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

Bouwman, F; Orini, S; Gandolfo, F; Altomare, D; Festari, C; Agosta, F; Arbizu, J; ... EANM-EAN Task Force for the Prescription of FDG-PET for Dementin, .; + view all (2018) Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia. European Journal of Nuclear Medicine and Molecular Imaging , 45 (9) pp. 1526-1533. 10.1007/s00259-018-4034-z. Green open access

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Abstract

PURPOSE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Type: Article
Title: Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00259-018-4034-z
Publisher version: https://doi.org/10.1007/s00259-018-4034-z
Language: English
Additional information: © The Author(s) 2018. This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/ licenses/ by/4.0/.
Keywords: Agrammatic, Dementia, FDG-PET, Logopenic, Neurodegenerative, Primary progressive aphasia, PPA, Semantic
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/10049284
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