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Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia

Nestor, PJ; Altomare, D; Festari, C; Drzezga, A; Rivolta, J; Walker, Z; Bouwman, F; ... Frisoni, GB; + view all (2018) Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia. European Journal of Nuclear Medicine and Molecular Imaging , 45 (9) pp. 1509-1525. 10.1007/s00259-018-4035-y. Green open access

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Abstract

Aim: To assess the clinical utility of FDG-PET as a diagnostic aid for differentiating Alzheimer’s disease (AD; both typical and atypical forms), dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD) and non-degenerative pseudodementia. Methods: A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted on six different diagnostic scenarios using the Delphi method. Results: The level of empirical study evidence for the use of FDG-PET was considered good for the discrimination of DLB and AD; fair for discriminating FTLD from AD; poor for atypical AD; and lacking for discriminating DLB from FTLD, AD from VaD, and for pseudodementia. Delphi voting led to consensus in all scenarios within two iterations. Panellists supported the use of FDG-PET for all PICOs—including those where study evidence was poor or lacking—based on its negative predictive value and on the assistance it provides when typical patterns of hypometabolism for a given diagnosis are observed. Conclusion: Although there is an overall lack of evidence on which to base strong recommendations, it was generally concluded that FDG-PET has a diagnostic role in all scenarios. Prospective studies targeting diagnostically uncertain patients for assessing the added value of FDG-PET would be highly desirable.

Type: Article
Title: Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00259-018-4035-y
Publisher version: https://doi.org/10.1007/s00259-018-4035-y
Language: English
Additional information: This version is the version of the record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: FDG-PET, Alzheimer’s disease, Atypical Alzheimer, Dementia with Lewy bodies, Frontotemporal lobar degeneration, Vascular dementia, Pseudodementia, PICO, Delphi
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10064429
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