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

A Drzezga, D Altomare, C Festari, J Arbizu, S Orini, K Herholz, P Nestor, F Agosta, F Bouwman, F Nobili, Z Walker, GB Frisoni, M Boccardi, EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders for the

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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. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature
Original languageEnglish
Pages (from-to)1487-1496
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number9
DOIs
Publication statusPublished - 2018

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    Drzezga, A., Altomare, D., Festari, C., Arbizu, J., Orini, S., Herholz, K., Nestor, P., Agosta, F., Bouwman, F., Nobili, F., Walker, Z., Frisoni, GB., Boccardi, M., & for the, EANM-EAN. T. F. F. T. P. O. FDG-PET. F. D. N. D. (2018). Diagnostic utility of 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) in asymptomatic subjects at increased risk for Alzheimer’s disease. European Journal of Nuclear Medicine and Molecular Imaging, 45(9), 1487-1496. https://doi.org/10.1007/s00259-018-4032-1