Publicaciones científicas

Amyloid-PET and 18 F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias

01-nov-2020 | Revista: Lancet Neurology

Gaël Chételat  1 , Javier Arbizu  2 , Henryk Barthel  3 , Valentina Garibotto  4 , Ian Law  5 , Silvia Morbelli  6 , Elsmarieke van de Giessen  7 , Federica Agosta  8 , Frederik Barkhof  9 , David J Brooks  10 , Maria C Carrillo  11 , Bruno Dubois  12 , Anders M Fjell  13 , Giovanni B Frisoni  14 , Oskar Hansson  15 , Karl Herholz  16 , Brian F Hutton  17 , Clifford R Jack Jr  18 , Adriaan A Lammertsma  19 , Susan M Landau  20 , Satoshi Minoshima  21 , Flavio Nobili  22 , Agneta Nordberg  23 , Rik Ossenkoppele  24 , Wim J G Oyen  25 , Daniela Perani  26 , Gil D Rabinovici  27 , Philip Scheltens  28 , Victor L Villemagne  29 , Henrik Zetterberg  30 , Alexander Drzezga  31


Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and 18F-fluorodeoxyglucose (18F-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information.

However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise.

We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia.

We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and 18F-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation.

We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies.

CITA DEL ARTÍCULO  Lancet Neurol. 2020 Nov;19(11):951-962. doi: 10.1016/S1474-4422(20)30314-8