Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia

Femke Bouwman, Stefania Orini, Federica Gandolfo, Daniele Altomare, Cristina Festari, Federica Agosta, Javier Arbizu, Alexander Drzezga, Peter Nestor, Flavio Nobili, Zuzana Walker, Silvia Morbelli, Marina Boccardi, EANM-EAN Task Force Prescription F

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Abstract

A joint effort of the European Association of Nuclear Medicine (EANM) and the European Academy of Neurology (EAN) aims at clinical guidance for the use of FDG-PET in neurodegenerative diseases. This paper addresses the diagnostic utility of FDG-PET over clinical/neuropsychological assessment in the differentiation of the three forms of primary progressive aphasia (PPA). Seven panelists were appointed by the EANM and EAN and a literature search was performed by using harmonized PICO (Population, Intervention, Comparison, Outcome) question keywords. The studies were screened for eligibility, and data extracted to assess their methodological quality. Critical outcomes were accuracy indices in differentiating different PPA clinical forms. Subsequently Delphi rounds were held with the extracted data and quality assessment to reach a consensus based on both literature and expert opinion. Critical outcomes for this PICO were available in four of the examined papers. The level of formal evidence supporting clinical utility of FDG-PET in differentiating among PPA variants was considered as poor. However, the consensual recommendation was defined on Delphi round I, with six out of seven panelists supporting clinical use. Quantitative evidence demonstrating utility or lack thereof is still missing. Panelists decided consistently to provide interim support for clinical use based on the fact that a typical atrophy or metabolic pattern is needed for PPA according to the diagnostic criteria, and the synaptic failure detected by FDG-PET is an earlier phenomenon than atrophy. Also, a normal FDG-PET points to a non-neurodegenerative cause.
Original languageEnglish
Pages (from-to)1526-1533
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number9, SI
DOIs
Publication statusPublished - Jul 1 2018

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Primary Progressive Aphasia
Differential Diagnosis
Neurology
Atrophy
Nuclear Medicine
Expert Testimony
Neurodegenerative Diseases
Population
Consensus

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Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia. / Bouwman, Femke; Orini, Stefania; Gandolfo, Federica; Altomare, Daniele; Festari, Cristina; Agosta, Federica; Arbizu, Javier; Drzezga, Alexander; Nestor, Peter; Nobili, Flavio; Walker, Zuzana; Morbelli, Silvia; Boccardi, Marina; F, EANM-EAN Task Force Prescription.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 45, No. 9, SI, 01.07.2018, p. 1526-1533.

Research output: Contribution to journalArticle

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