Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia

PJ Nestor, D Altomare, C Festari, A Drzezga, J Rivolta, Z Walker, F Bouwman, S Orini, I Law, F Agosta, J Arbizu, M Boccardi, F Nobili, GB Frisoni

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To assess the clinical utility of FDG-PET as a diagnostic aid for differentiating Alzheimer’s disease (AD; both typical and atypical forms), dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD) and non-degenerative pseudodementia. Methods: A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted on six different diagnostic scenarios using the Delphi method. Results: The level of empirical study evidence for the use of FDG-PET was considered good for the discrimination of DLB and AD; fair for discriminating FTLD from AD; poor for atypical AD; and lacking for discriminating DLB from FTLD, AD from VaD, and for pseudodementia. Delphi voting led to consensus in all scenarios within two iterations. Panellists supported the use of FDG-PET for all PICOs—including those where study evidence was poor or lacking—based on its negative predictive value and on the assistance it provides when typical patterns of hypometabolism for a given diagnosis are observed. Conclusion: Although there is an overall lack of evidence on which to base strong recommendations, it was generally concluded that FDG-PET has a diagnostic role in all scenarios. Prospective studies targeting diagnostically uncertain patients for assessing the added value of FDG-PET would be highly desirable. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature
Original languageEnglish
Pages (from-to)1509-1525
Number of pages17
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number9
DOIs
Publication statusPublished - 2018

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