Clinical impact of 18F-FDG-PET among memory clinic patients with uncertain diagnosis

Perini, Giulia; Rodriguez‐Vieitez, Elena; Kadir, Ahmadul; Sala, Arianna; Savitcheva, Irina; Nordberg, Agneta

doi:10.1007/s00259-020-04969-7

Cited by 18 publications

(21 citation statements)

References 47 publications

(75 reference statements)

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“…Moreover, use of FDG-PET has also been recommended by the European Association of Nuclear Medicine and the European Academy of Neurology (EANM-EAN) both in people with dementia ( Nobili and others 2018 ) and in mild cognitive impairment (MCI) ( Arbizu and others 2018 ; Nobili and others 2018 ). Recently, it has been observed that FDG-PET has significant clinical utility not only for early diagnosis but also helps in differential diagnosis of people with uncertain diagnosis of dementia ( Perini and others 2020 )…”

Section: Fdg-pet Imaging In Admentioning

confidence: 99%

Alzheimer’s Dementia: The Emerging Role of Positron Emission Tomography

Tripathi

Murray

2021

Neuroscientist

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Alzheimer’s disease (AD) is the most common cause of dementia and accounts for approximately 50% to 80% of all cases of dementia. The diagnosis of probable AD is based on clinical criteria and overlapping clinical features pose a challenge to accurate diagnosis. However, neuroimaging has been included as a biomarker in various published criteria for the diagnosis of probable AD, in the absence of a confirmatory diagnostic test during life. Advances in neuroimaging techniques and their inclusion in diagnostic and research criteria for the diagnosis of AD includes the use of positron emission tomography (PET) imaging as a biomarker in various therapeutic and prognostic studies in AD. The development and application of a range of PET tracers will allow more detailed assessment of people with AD and will improve diagnostic specificity and targeted therapy of AD. The aim of this review is to summarize current evidence on PET imaging using the non-specific tracer [18F]fluorodeoxyglucose and specific tracers that target amyloid and tau pathology in people with AD.

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Section: Fdg-pet Imaging In Admentioning

confidence: 99%

Alzheimer’s Dementia: The Emerging Role of Positron Emission Tomography

Tripathi

Murray

2021

Neuroscientist

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“…Therefore, the need for earlier and more accurate detection of AD becomes critical. The earliest detectable changes in AD are neuropathological which are diagnosed by functional brain imaging, i.e., positron emission tomography (PET) [1] and magnetic resonance imaging (MRI) [2]. Additional diagnostic tests in clinical routine practice entail the use of the core AD cerebral spinal fluid (CSF) biomarkers, i.e., phosphorylated TAU, total TAU, and the Aβ 1-42 /Aβ 1-40 ratio [3].…”

Section: Introductionmentioning

confidence: 99%

Serum Corticosterone and Insulin Resistance as Early Biomarkers in the hAPP23 Overexpressing Mouse Model of Alzheimer’s Disease

Hendrickx

Moudt

Calus

et al. 2021

IJMS

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Increasing epidemiological evidence highlights the association between systemic insulin resistance and Alzheimer’s disease (AD). As insulin resistance can be caused by high-stress hormone levels and since hypercortisolism appears to be an important risk factor of AD, we aimed to investigate the systemic insulin functionality and circulating stress hormone levels in a mutant humanized amyloid precursor protein (APP) overexpressing (hAPP23+/−) AD mouse model. Memory and spatial learning of male hAPP23+/− and C57BL/6 (wild type, WT) mice were assessed by a Morris Water Maze (MWM) test at the age of 4 and 12 months. The systemic metabolism was examined by intraperitoneal glucose and insulin tolerance tests (GTT, ITT). Insulin and corticosterone levels were determined in serum. In the hippocampus, parietal and occipital cortex of hAPP23+/− brains, amyloid-beta (Aβ) deposits were present at 12 months of age. MWM demonstrated a cognitive decline in hAPP23+/− mice at 12 but not at 4 months, evidenced by increasing total path lengths and deteriorating probe trials compared to WT mice. hAPP23+/− animals presented increased serum corticosterone levels compared to WT mice at both 4 and 12 months. hAPP23+/− mice exhibited peripheral insulin resistance compared to WT mice at 4 months, which stabilized at 12 months of age. Serum insulin levels were similar between genotypes at 4 months of age but were significantly higher in hAPP23+/− mice at 12 months of age. Peripheral glucose homeostasis remained unchanged. These results indicate that peripheral insulin resistance combined with elevated circulating stress hormone levels could be potential biomarkers of the pre-symptomatic phase of AD.

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“…Recently, important clinical studies are been carried out to stablish the clinical impact of amyloid and 18 F-FDG PET in the clinical practice (11)(12)(13)(14)(15). Although there is now significant evidence about the clinical impact of incorporating these tools in the assessment of patients with cognitive impairment, most of the literature comes from high-income countries.…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of PET With 18F-FDG and 11C-PIB in Patients With Dementia in a Developing Country

et al. 2021

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Introduction: The objective of this study was to evaluate the clinical impact PET with 18F-FDG and 11C-PIB in patients with dementia in a developing country.Methodology: Retrospective study of the patients referred for the evaluation of dementia to the only PET center in Uruguay. A total of 248 patients were identified, from which 70 patients were included based on the availability of medical history and clinical follow-up. Main outcomes included change in diagnosis, diagnostic dilemma and AD treatment. We evaluated the association of clinical outcomes with PET concordance with baseline diagnosis, diagnostic dilemma, level of education, AD pathology/Non-AD pathology (AD/Non-AD), baseline diagnosis and 11C-PIB PET result.Results: Baseline clinical diagnosis was concordant with 18F-FDG and 11C-PIB PET results in 64.7 and 77.1% of the patients, respectively. Change in diagnosis after PET was identified in 30.0% of the patients and was associated with discordant 18F-FDG (p = 0.002) and 11C-PIB (p < 0.001) PET results, previous diagnostic dilemma (p = 0.005), low education (p = 0.027), Non-AD baseline diagnosis (p = 0.027), and negative 11C-PIB PET result (p < 0.001). Only the last variable remained significant in the multivariate analysis (adjusted p = 0.038). Diagnostic dilemma decreased after PET from 15.7 to 7.1% (p = 0.11) and was associated with Non-AD diagnosis (p = 0.002) and negative 11C-PIB PET result (p = 0.003). Change in AD treatment after PET occurred in 45.7% of the patients.Conclusion:18F-FDG and 11C-PIB PET had a significant clinical impact in terms of change in diagnosis and treatment in patients with dementia in a developing country, similar to that reported in high-income countries.

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Clinical impact of 18F-FDG-PET among memory clinic patients with uncertain diagnosis

Cited by 18 publications

References 47 publications

Alzheimer’s Dementia: The Emerging Role of Positron Emission Tomography

Alzheimer’s Dementia: The Emerging Role of Positron Emission Tomography

Serum Corticosterone and Insulin Resistance as Early Biomarkers in the hAPP23 Overexpressing Mouse Model of Alzheimer’s Disease

Clinical Impact of PET With 18F-FDG and 11C-PIB in Patients With Dementia in a Developing Country

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