TY - JOUR
T1 - Clinical utility of FDG-PET in amyotrophic lateral sclerosis and Huntington’s disease
AU - for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders
AU - Agosta, Federica
AU - Altomare, Daniele
AU - Festari, Cristina
AU - Orini, Stefania
AU - Gandolfo, Federica
AU - Boccardi, Marina
AU - Arbizu, Javier
AU - Bouwman, Femke
AU - Drzezga, Alexander
AU - Nestor, Peter
AU - Nobili, Flavio
AU - Walker, Zuzana
AU - Pagani, Marco
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Aim: To evaluate the incremental value of FDG-PET over clinical tests in: (i) diagnosis of amyotrophic lateral sclerosis (ALS); (ii) picking early signs of neurodegeneration in patients with a genetic risk of Huntington’s disease (HD); and detecting metabolic changes related to cognitive impairment in (iii) ALS and (iv) HD patients. Methods: Four comprehensive literature searches were conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted using the Delphi method on these four diagnostic scenarios. Results: The availability of evidence was good for FDG-PET utility to support the diagnosis of ALS, poor for identifying presymptomatic subjects carrying HD mutation who will convert to HD, and lacking for identifying cognitive-related metabolic changes in both ALS and HD. After the Delphi consensual procedure, the panel did not support the clinical use of FDG-PET for any of the four scenarios. Conclusion: Relative to other neurodegenerative diseases, the clinical use of FDG-PET in ALS and HD is still in its infancy. Once validated by disease-control studies, FDG-PET might represent a potentially useful biomarker for ALS diagnosis. FDG-PET is presently not justified as a routine investigation to predict conversion to HD, nor to detect evidence of brain dysfunction justifying cognitive decline in ALS and HD.
AB - Aim: To evaluate the incremental value of FDG-PET over clinical tests in: (i) diagnosis of amyotrophic lateral sclerosis (ALS); (ii) picking early signs of neurodegeneration in patients with a genetic risk of Huntington’s disease (HD); and detecting metabolic changes related to cognitive impairment in (iii) ALS and (iv) HD patients. Methods: Four comprehensive literature searches were conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted using the Delphi method on these four diagnostic scenarios. Results: The availability of evidence was good for FDG-PET utility to support the diagnosis of ALS, poor for identifying presymptomatic subjects carrying HD mutation who will convert to HD, and lacking for identifying cognitive-related metabolic changes in both ALS and HD. After the Delphi consensual procedure, the panel did not support the clinical use of FDG-PET for any of the four scenarios. Conclusion: Relative to other neurodegenerative diseases, the clinical use of FDG-PET in ALS and HD is still in its infancy. Once validated by disease-control studies, FDG-PET might represent a potentially useful biomarker for ALS diagnosis. FDG-PET is presently not justified as a routine investigation to predict conversion to HD, nor to detect evidence of brain dysfunction justifying cognitive decline in ALS and HD.
KW - Amyotrophic lateral sclerosis
KW - Behavioral abnormalities
KW - Cognitive impairment
KW - FDG-PET
KW - Huntington’s disease
KW - Mutation gene carrier
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U2 - 10.1007/s00259-018-4033-0
DO - 10.1007/s00259-018-4033-0
M3 - Article
AN - SCOPUS:85046159935
SP - 1
EP - 11
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
ER -