TY - JOUR
T1 - Diagnostic utility of 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) in asymptomatic subjects at increased risk for Alzheimer’s disease
AU - for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders
AU - Drzezga, Alexander
AU - Altomare, Daniele
AU - Festari, Cristina
AU - Arbizu, Javier
AU - Orini, Stefania
AU - Herholz, Karl
AU - Nestor, Peter
AU - Agosta, Federica
AU - Bouwman, Femke
AU - Nobili, Flavio
AU - Walker, Zuzana
AU - Frisoni, Giovanni Battista
AU - Boccardi, Marina
PY - 2018/5/13
Y1 - 2018/5/13
N2 - Purpose: To assess the clinical utility of 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of early signs of neurodegeneration in conditions of increased risk for Alzheimer’s disease (AD) as defined by: subjective cognitive decline (SCD), evidence of cerebral amyloid-pathology, apolipoprotein E (APOE) ε4-positive genotype, or autosomal dominant forms of AD (ADAD) in asymptomatic stages. Methods: A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted using the Delphi method on three different diagnostic scenarios. Results: The level of empirical study evidence for the use of FDG-PET to detect meaningful early signs of neurodegeneration was considered to be poor for ADAD and lacking for SCD and asymptomatic persons at risk, based on APOE ε4-positive genotype or cerebral amyloid pathology. Consequently, and consistent with current diagnostic criteria, panelists decided not to recommend routine clinical use of FDG-PET in these situations and to currently mainly reserve it for research purposes. Conclusion: Currently, there is limited evidence on which to base recommendations regarding the clinical routine use of FDG-PET to detect diagnostically meaningful early signs of neurodegeneration in asymptomatic subjects with ADAD, with APOE ε4-positive genotype, or with cerebral amyloid pathology, and in subjects with SCD. Future prospective studies are warranted and in part already ongoing, aiming to assess the added value of FDG-PET in this context beyond research applications.
AB - Purpose: To assess the clinical utility of 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of early signs of neurodegeneration in conditions of increased risk for Alzheimer’s disease (AD) as defined by: subjective cognitive decline (SCD), evidence of cerebral amyloid-pathology, apolipoprotein E (APOE) ε4-positive genotype, or autosomal dominant forms of AD (ADAD) in asymptomatic stages. Methods: A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted using the Delphi method on three different diagnostic scenarios. Results: The level of empirical study evidence for the use of FDG-PET to detect meaningful early signs of neurodegeneration was considered to be poor for ADAD and lacking for SCD and asymptomatic persons at risk, based on APOE ε4-positive genotype or cerebral amyloid pathology. Consequently, and consistent with current diagnostic criteria, panelists decided not to recommend routine clinical use of FDG-PET in these situations and to currently mainly reserve it for research purposes. Conclusion: Currently, there is limited evidence on which to base recommendations regarding the clinical routine use of FDG-PET to detect diagnostically meaningful early signs of neurodegeneration in asymptomatic subjects with ADAD, with APOE ε4-positive genotype, or with cerebral amyloid pathology, and in subjects with SCD. Future prospective studies are warranted and in part already ongoing, aiming to assess the added value of FDG-PET in this context beyond research applications.
KW - ADAD
KW - Alzheimer’s disease
KW - Amyloidosis
KW - APOE
KW - FDG-PET
KW - PSEN1
KW - SCD
UR - http://www.scopus.com/inward/record.url?scp=85046751601&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046751601&partnerID=8YFLogxK
U2 - 10.1007/s00259-018-4032-1
DO - 10.1007/s00259-018-4032-1
M3 - Article
AN - SCOPUS:85046751601
SP - 1
EP - 10
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
ER -