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Cited by 32Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsMedical Imaging Techniques and Applications

Amyloid imaging for differential diagnosis of dementia: incremental value compared to clinical diagnosis and [18F]FDG PET

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Hellwig, Sabine, Frings, Lars, Bormann, Tobias, Vach, Werner, Buchert, Ralph, Meyer, Philipp T.·2019·European Journal of Nuclear Medicine and Molecular Imaging
DOI 10.1007/s00259-018-4111-3PMC PMC6333717
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Abstract

Cerebral beta-amyloid and regional glucose metabolism assessed by positron emission tomography (PET) are used as diagnostic biomarkers for Alzheimer’s disease (AD). The present study validates the incremental diagnostic value of amyloid PET in addition to clinical diagnosis and [ 18 F]FDG PET in a real-life memory clinic population. Of 138 consecutive patients with cognitive impairment who received combined [ 18 F]FDG and [ 11 C]PIB PET, 84 were diagnosed with major neurocognitive disorder (DSM-5) and included. Baseline clinical and [ 18 F]FDG PET diagnoses were independently established with and without access to amyloid PET results and were dichotomized into AD or non-AD disorders. The incremental value of amyloid PET was evaluated in terms of: (1) the change in clinical and [ 18 F]FDG PET diagnoses, (2) the change in agreement between clinical and [ 18 F]FDG PET diagnoses, and (3) diagnostic accuracy using an interdisciplinary consensus diagnosis after an extended follow-up (2.4 ± 1.3 years after PET) as the reference. After disclosure of the amyloid PET results, clinical and [ 18 F]FDG PET diagnoses changed in 23% and 18% of patients, respectively, and agreement between both ratings increased from 62% to 86% ( p < 0.001). The accuracy of clinical and [ 18 F]FDG PET diagnoses improved from 71% to 89% ( p < 0.01) and from 76% to 94% ( p < 0.001), respectively. The additional value of amyloid PET was rather uniform in relation to age at onset and consistency with appropriate use criteria. Amyloid PET provides significant incremental diagnostic value beyond clinical and [ 18 F]FDG PET diagnoses of AD. Given the high diagnostic accuracy of combined clinical and amyloid PET assessment, further studies are needed to clarify the role of an additional [ 18 F]FDG PET scan in these patients.

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  • Studies suggest amyloid PET provides incremental diagnostic value beyond clinical and FDG-PET diagnoses of AD.

    “Studies have suggested that amyloid PET provides incremental diagnostic value beyond clinical and FDG-PET diagnoses of AD.”

    From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [167]

  • Compared to FDG-PET, amyloid PET is more sensitive (89% vs 73%) but less specific (83% vs 98%) for differential diagnosis between AD and FTD.

    “Compared to FDG-PET, amyloid PET is more sensitive (89% vs 73%) but less specific (83% compared to 98%) for the differential diagnosis between AD and FTD [167, 168].”

    From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [167]

    The Results (Table 4; page unavailable) give sensitivity and specificity for FDG-PET diagnoses before and after disclosure of amyloid PET results, not a head-to-head comparison of the two scans for AD versus FTD. The paper groups FTD with other non-AD diagnoses, and the searched passages do not report the claimed 89% versus 73% sensitivity or 83% versus 98% specificity. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Hellwig, S., Frings, L., Bormann, T., Vach, W., Buchert, R., & Meyer, P. T.
Affiliations
  • University of Freiburg (DE)
  • University Medical Center Hamburg-Eppendorf (DE)
Corresponding author
Hellwig, Sabine
ORCID
Venue
European Journal of Nuclear Medicine and Molecular Imaging
Publisher
Springer Science and Business Media LLC
Published
2018-08-10
Volume
46
Issue
2
Pages
312-323
ISSN
  • 1619-7070 (ISSN-L)
  • 1619-7089
DOI
10.1007/s00259-018-4111-3
PMC
PMC6333717
OpenAlex
W2885265215
Cited by
32
References
3
Citations by year
2026: 2 · 2025: 7 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 2 · 2020: 7 · 2019: 2
FWCI
2.16
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Nuclear Medicine and Molecular Imaging (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
Keywords
amyloid PET, Alzheimer's disease, differential diagnosis of dementia, 18F-FDG PET, 11C-PiB PET, incremental diagnostic value, major neurocognitive disorder, cognitive impairment, diagnostic accuracy, diagnosis, regional glucose metabolism, memory clinic patients
MeSH terms
Aged, Amyloid, Dementia, Diagnosis, Differential, Female, Humans, Male, Area Under Curve, Fluorodeoxyglucose F18, Positron-Emission Tomography

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