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  • Title: Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia.
    Author: Nestor PJ, Altomare D, Festari C, Drzezga A, Rivolta J, Walker Z, Bouwman F, Orini S, Law I, Agosta F, Arbizu J, Boccardi M, Nobili F, Frisoni GB, EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders.
    Journal: Eur J Nucl Med Mol Imaging; 2018 Jul; 45(9):1509-1525. PubMed ID: 29736698.
    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.
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