Dement Neurocogn Disord.  2024 Jan;23(1):54-66. 10.12779/dnd.2024.23.1.54.

The Usefulness of 18 F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis

Affiliations
  • 1Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
  • 2Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
  • 4Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea.
  • 5Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea.
  • 6Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea.
  • 7Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea.
  • 8Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 9Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea.
  • 10Department of Neurology, National Medical Center, Seoul, Korea.
  • 11Dr Shin’s Neurology Clinic, Wonju, Korea.
  • 12Department of Neurology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 13Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea.
  • 14Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
  • 15Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
  • 16Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 17Department of Neurology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
  • 18Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
  • 19Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
  • 20Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
  • 21Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
  • 22Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 23Department of Neurology, Myungji Hospital, Goyang, Korea.
  • 24Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 25Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
  • 26Department of Neurology, Seoul National University Hospital, Seoul, Korea.
  • 27Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 28Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.

Abstract

Background and Purpose
Dementia subtypes, including Alzheimer’s dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18 F-Fluorodeoxyglucose Positron Emission Tomography ( 18 F-FDG PET) in differentiating these subtypes for precise treatment and management.
Methods
A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18 F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes.
Results
From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88–0.98) and specificity was 0.84 (95% CI, 0.70–0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70–0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80–0.91) and the specificity was 0.88 (95% CI, 0.80–0.91). The studies mostly used case-control designs with visual and quantitative assessments.
Conclusions
18 F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.

Keyword

Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Dementia; Meta-Analysis; Alzheimer’s Disease; Frontotemporal Dementia; Lewy Body Disease
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