Diagnostic utility of 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) in asymptomatic subjects at increased risk for Alzheimer's disease

EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1487-1496
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number9
DOIs
Publication statusPublished - Jul 2018

Keywords

  • Alzheimer Disease/diagnostic imaging
  • Apolipoproteins E/genetics
  • Brain/diagnostic imaging
  • Fluorodeoxyglucose F18
  • Genetic Predisposition to Disease
  • Humans
  • Positron-Emission Tomography
  • Prospective Studies
  • Radiopharmaceuticals

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