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

Nestor, Peter J.; Altomare, Daniele; Festari, Cristina; Drzezga, Alexander; Rivolta, Jasmine; Walker, Zuzana; Bouwman, Femke H.; Orini, Stefania; Law, Ian; Agosta, Federica; Arbizu, Javier; Boccardi, Marina; Nobili, Flavio; Frisoni, Giovanni B.

doi:10.1007/s00259-018-4035-y

Cited by 93 publications

(76 citation statements)

References 89 publications

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“…FDG-PET to differentiate AD from FTLD (PICO 9) Critical outcomes were available in five of the examined papers [26]. These papers found 80%-99% sensitivity range, 63%-98% specificity range, 87%-89.2% accuracy range [65,[68][69][70], 0.91-0.97 AUC range [65,70], 98% PPV, 74% NPV, 29.88 LR+, 0.25 LRÀ [70], and an increased accuracy for the classification of FTLD with respect to AD by using semiquantitative assessment of FDG-PET [71].…”

Section: Fdg-pet To Differentiate Between Dlb and Ad (Pico 8)mentioning

confidence: 99%

European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

Nobili

Arbizu

Bouwman

et al. 2018

Euro J of Neurology

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Section: Fdg-pet To Differentiate Between Dlb and Ad (Pico 8)mentioning

confidence: 99%

European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

Nobili

Arbizu

Bouwman

et al. 2018

Euro J of Neurology

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160

178

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“…In order to facilitate the communication on available evidence with panelists, we produced, besides the tables with all extracted data for each PICO, summary of findings tables reporting the outcomes assessed globally across papers, and abstracts better elucidating all findings (see (23)(24)(25)(26)(27)(28)(29). These explained both the quantitative data as based on the methodological assessment described, and the "qualitative" findings, as based on the pattern of hypometabolism correlated to the target disorders for each PICO.…”

Section: Summaries Of Evidence Assessmentmentioning

confidence: 99%

Assessing FDG-PET diagnostic accuracy studies to develop recommendations for clinical use in dementia

Boccardi

Festari

Altomare

et al. 2018

Eur J Nucl Med Mol Imaging

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An incremental diagnostic value of FDG-PET versus clinical diagnosis or lack thereof cannot be derived from the current literature. Many of the observed limitations may easily be overcome, and we outlined them as research priorities to improve the quality of current evidence. Such improvement is necessary to outline evidence-based guidelines. The available data were anyway provided to expert clinicians who defined interim recommendations.

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“…Panelists also mentioned that solving standardization issues (e.g., for scan reading or normality threshold) may overcome some of the current heterogeneity in FDG-PET diagnostic performance [16, 17], as did also the other literature reviews within the EANM-EAN Initiative [18–23]. …”

Section: Discussionmentioning

confidence: 99%

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

Bouwman

Orini

Gandolfo

et al. 2018

Eur J Nucl Med Mol Imaging

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PurposeA 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).MethodsSeven 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.ResultsCritical 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.ConclusionsQuantitative 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.

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

Cited by 93 publications

References 89 publications

European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

Assessing FDG-PET diagnostic accuracy studies to develop recommendations for clinical use in dementia

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

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

Cited by 93 publications

References 89 publications

European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain 18F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain 18F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

Assessing FDG-PET diagnostic accuracy studies to develop recommendations for clinical use in dementia

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

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European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus