Peter J Nestor1, Daniele Altomare2,3, Cristina Festari2,3, Alexander Drzezga4, Jasmine Rivolta2, Zuzana Walker5, Femke Bouwman6, Stefania Orini7, Ian Law8, Federica Agosta9, Javier Arbizu10, Marina Boccardi11,12, Flavio Nobili13, Giovanni Battista Frisoni2,14,15. 1. Queensland Brain Institute, University of Queensland and at the Mater Hospital Brisbane, Brisbane, Australia. p.nestor@uq.edu.au. 2. LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy. 3. Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy. 4. Department of Nuclear Medicine, University Hospital of Cologne, University of Cologne and German Center for Neurodegenerative Diseases (DZNE), Cologne, Germany. 5. Division of Psychiatry & Essex Partnership University NHS Foundation Trust, University College London, London, UK. 6. Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands. 7. Alzheimer Operative Unit, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy. 8. Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 9. Neuroimaging Research Unit and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. 10. Department of Nuclear Medicine, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain. 11. LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy. marina.boccardi@unige.ch. 12. LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, University of Geneva, Chemin du Petit-Bel-Air, 2, 1225, Chene-Bourg, Geneva, Switzerland. marina.boccardi@unige.ch. 13. Department of Neuroscience (DINOGMI), University of Genoa and Polyclinic IRCCS San Martino-IST, Genoa, Italy. 14. LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, University of Geneva, Chemin du Petit-Bel-Air, 2, 1225, Chene-Bourg, Geneva, Switzerland. 15. Memory Clinic, University Hospitals, Geneva, Switzerland.
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.
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.
Authors: N Okamura; H Arai; M Higuchi; M Tashiro; T Matsui; X S Hu; A Takeda; M Itoh; H Sasaki Journal: Prog Neuropsychopharmacol Biol Psychiatry Date: 2001-02 Impact factor: 5.067
Authors: Sid Gilman; Robert A Koeppe; Roderick Little; Hyonggin An; Larry Junck; Bruno Giordani; Carol Persad; Mary Heumann; Kris Wernette Journal: Exp Neurol Date: 2005-02 Impact factor: 5.330
Authors: Laura K Teune; Anna L Bartels; Bauke M de Jong; Antoon T M Willemsen; Silvia A Eshuis; Jeroen J de Vries; Joost C H van Oostrom; Klaus L Leenders Journal: Mov Disord Date: 2010-10-30 Impact factor: 10.338
Authors: Norman L Foster; Judith L Heidebrink; Christopher M Clark; William J Jagust; Steven E Arnold; Nancy R Barbas; Charles S DeCarli; R Scott Turner; Robert A Koeppe; Roger Higdon; Satoshi Minoshima Journal: Brain Date: 2007-08-18 Impact factor: 13.501
Authors: Rene L Utianski; Hugo Botha; Peter R Martin; Christopher G Schwarz; Joseph R Duffy; Heather M Clark; Mary M Machulda; Alissa M Butts; Val J Lowe; Clifford R Jack; Matthew L Senjem; Anthony J Spychalla; Jennifer L Whitwell; Keith A Josephs Journal: Brain Lang Date: 2019-08-13 Impact factor: 2.381
Authors: Matteo Pardini; Edward D Huey; Salvatore Spina; William C Kreisl; Silvia Morbelli; Eric M Wassermann; Flavio Nobili; Bernardino Ghetti; Jordan Grafman Journal: Neurology Date: 2019-01-30 Impact factor: 9.910
Authors: Ming-Kai Chen; Adam P Mecca; Mika Naganawa; Jean-Dominique Gallezot; Takuya Toyonaga; Jayanta Mondal; Sjoerd J Finnema; Shu-Fei Lin; Ryan S O'Dell; Julia W McDonald; Hannah R Michalak; Brent Vander Wyk; Nabeel B Nabulsi; Yiyun Huang; Amy Ft Arnsten; Christopher H van Dyck; Richard E Carson Journal: J Cereb Blood Flow Metab Date: 2021-03-24 Impact factor: 6.200