Publicaciones científicas
Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia
Nestor PJ (1), Altomare D (2,3), Festari C (2,3), Drzezga A (4), Rivolta J (2), Walker Z (5), Bouwman F (6), Orini S (7), Law I (8), Agosta F (9), Arbizu J (10), Boccardi M (11,12), Nobili F (13), Frisoni GB (2,14,15); EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders.
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.
CITA DEL ARTÍCULO Eur J Nucl Med Mol Imaging. 2018 Jul;45(9):1509-1525. doi: 10.1007/s00259-018-4035-y
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