TABLE 5

18F-FDG PET and AD Diagnostic Studies Reporting Likelihood Ratios

Reference and study typeDiagnostic standardSubjectsLikelihood ratios
Panegyres et al. 2009 (35), prospective cohort study of diagnostic utility of 18F-FDG PETClinical diagnosis based on longitudinal long-term assessmentCommunity-dwelling subjects presented to primary care center for cognitive complaints. Final clinical diagnosis was early-stage AD (n = 49), non-AD dementia (n = 29), depression (n = 11), or miscellaneous (n = 13).Positive likelihood ratio for 18F-FDG PET scan considered consistent with AD was 4.11 (95% CI, 2.29–7.32), suggesting increase in likelihood of final diagnosis of AD when diagnosed on 18F-FDG PET with AD. Negative likelihood ratio for AD was 0.27 (95% CI, 0.16–0.46), suggesting more significant decrease in likelihood of final diagnosis of AD when 18F-FDG PET findings are negative for AD. Probability before 18F-FDG PET that patient had AD was 48%. After 18F-FDG PET, probability increased to 79%, indicating that 18F-FDG PET increases diagnosis probability of early-onset AD from 48% to 79%.
Jagust et al., 2007 (39), historical cohort studyPostmortem diagnosisForty-four individuals with dementia, cognitive impairment, or normal cognitive function underwent clinical initial evaluation and PET and were followed up for approximately 4 y until final evaluation and 5 y until death and autopsy. Clinical, pathologic, and imaging diagnoses were categorized as AD or not AD.Positive likelihood ratio of 18F-FDG PET for AD diagnosis was 3.2, and negative likelihood ratio was 0.21.
Silverman et al., 2001 (42), multicenter retrospective analysisPostmortem diagnosisMulticenter retrospective analysis was performed on heterogeneous patient population.Positive likelihood ratio of 18F-FDG PET for AD diagnosis was 3.5, and negative likelihood ratio was 0.08. Positive likelihood ratio of 18F-FDG PET for presence of neurodegenerative disease of any kind was 4.2, and negative likelihood ratio was 0.075.