Abstract
Imaging that can detect pathophysiologic change in the brain holds great promise for diagnostic assessment of patients with Alzheimer disease (AD) and dementia. Although a previous metaanalysis centering on literature from 1990 to 2000 showed a summary accuracy of 86% for 18F-FDG PET for AD diagnosis, the clinical value was considered uncertain because of methodologic shortcomings. Review of the recent literature since 2000 demonstrates that the evidence for 18F-FDG PET in assessment of dementia has increased with new studies that include autopsy confirmation, wide-diagnostic-spectrum recruitment in primary care settings, historical and prospective cohort studies, and multicenter data analyses. These data support the role of 18F-FDG PET as an effective and useful adjunct to other diagnostic information in the assessment of patients with symptoms of dementia. Findings are in line with recently revised diagnostic criteria of AD that for the first time recognize the unique role of biomarker evidence in disease definition.
Footnotes
Published online Dec. 15, 2011.
Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the added diagnostic value of 18F-FDG PET in the assessment of dementia, compared with clinical assessment and follow-up alone; (2) the physiologic basis of cerebral glucose metabolism and its pathologic alterations in neurodegeneration; (3) recent literature reports of potential contributions of 18F-FDG PET in Alzheimer disease assessment; (4) the inclusion of biomarker evidence, including 18F-FDG PET, in new diagnostic criteria for Alzheimer disease; and (5) the impact of 18F-FDG PET on physician diagnostic confidence when assessing a patient with suspected dementia.
Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest.
CME Credit: SNM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNM designates each JNM continuing education article for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only credit commensurate with the extent of their participation in the activity.
For CE credit, participants can access this activity through the SNM Web site (http://www.snm.org/ce_online) through January 2013.
- © 2012 by the Society of Nuclear Medicine, Inc.