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Cited by 81Dementia and Cognitive Impairment ResearchMedical Imaging Techniques and ApplicationsAlzheimer's disease research and treatments

Fluorodeoxyglucose-Positron Emission Tomography in the differential diagnosis of early-onset dementia: a prospective, community-based study

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Panegyres, Peter K, Rogers, Jeffrey M, McCarthy, Michael, Campbell, Andrew, Wu, Jing Shan·2009·BMC Neurology
DOI 10.1186/1471-2377-9-41PMC PMC2736156
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Abstract

BACKGROUND: The aim of this study was to evaluate the diagnostic accuracy of positron emission tomography (PET) using F18 fluorodeoxyglucose (FDG) in the differential diagnosis of early-onset Alzheimer's disease (AD) and other dementias in a community-dwelling population. METHODS: A prospective sample of 102 individuals presenting consecutively to a primary care centre for examination of suspected early-onset dementing diseases. The mean age of symptom onset of dementia in our patients was 60.06 +/- 4.28 years (mean +/- 1 SD, 95% lower confidence intervals (CI) 54.75, upper 63.37). Patients were evaluated using standard clinical criteria for the diagnosis of dementia. Functional neuroimaging data was obtained and nuclear medicine physicians blind to the clinical diagnosis generated FDG-PET diagnoses. Final clinical diagnoses based on all available data were then established and compared against PET diagnoses. RESULTS: Forty-nine patients received a final clinical diagnosis of early-stage AD (MMSE score 20.97 +/- 5.10). There were 29 non-AD demented patients, 11 depressed patients and a miscellaneous group of 13 patients. Among patients with AD, the sensitivity and specificity of FDG-PET was 78% (95% CI: 66-90%) and 81% (95% CI: 68-86%), respectively. The positive likelihood ratio (PLR) for a FDG-PET scan positive for the diagnosis of AD was 4.11 (95% CI: 2.29-7.32) and negative likelihood ratio (NLR) for a negative FDG-PET scan in the absence of AD was 0.27 (95% CI: 0.16-0.46). The pre-test probability was 48% and post-test probability was 79.02%. The specificity of FDG-PET in the differential diagnosis of other dementias, including frontotemporal dementia, was greater than 95%. Recruitment methods in this study provide a sample that may be more representative of patients in the general population and indicate that FDG-PET imaging can contribute to the diagnosis of AD in younger adults with major increases in the positive likelihood rates and post-test probability. CONCLUSION: The high specificity of FDG-PET suggests this technique might help in the diagnosis of frontotemporal dementia and other forms of early-onset dementia.

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  • FDG-PET has significant diagnostic accuracy for differential diagnosis between AD and FTD with high specificity (>95%) in multiple studies.

    “FDG-PET has significant diagnostic accuracy for the differential diagnosis between AD and FTD with high specificity (>95%) in multiple studies [129–131].”

    From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [131]

    The Abstract Results report specificity greater than 95% for diagnosing other dementias, including FTD. But the Results table gives FTD specificity as 95%, not greater than 95%, and the Background reports 71% specificity for FTD versus AD or DLB in an earlier study. This paper therefore does not support the claim that multiple studies found greater-than-95% specificity for distinguishing AD from FTD. (LLM, conf=0.88)

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Research works printed but not linked: 2

  1. Jaeschke R Guyatt G Lijmer J Guyatt G, Rennie D Diagnostic tests User's Guide to the Medical Literature (2002) 2002 Chicago: AMA Press 121 140
  2. American Academy of Neurology Practice parameter for diagnosis and evaluation of dementia Report of the Quality Standards Subcommittee of the American Academy of Neurology Neurology 1994 44 2203 2206 7969988

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Authors
Panegyres, P. K., Rogers, J. M., McCarthy, M., Campbell, A., & Wu, J. S.
Affiliations
  • Government of Western Australia Department of Health (AU)
  • Royal Perth Hospital (AU)
  • Sir Charles Gairdner Hospital (AU)
Corresponding author
Panegyres, Peter K
ORCID
Venue
BMC Neurology
Publisher
Springer Science and Business Media LLC
Published
2009-08-12
Volume
9
Issue
1
Pages
41-41
ISSN
1471-2377 (ISSN-L)
DOI
10.1186/1471-2377-9-41
PMC
PMC2736156
OpenAlex
W2014847381
Cited by
81
References
52
Citations by year
2025: 4 · 2024: 3 · 2023: 1 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 8 · 2015: 9 · 2014: 11 · 2013: 6 · 2012: 5
FWCI
3.92
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Neurology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Bank (Australian Catholic University) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
early-onset dementia, Alzheimer's disease, differential diagnosis, diagnostic accuracy, frontotemporal dementia, community-dwelling older adults, likelihood ratios, sensitivity and specificity, neuroimaging diagnosis, primary care referral, post-test probability
MeSH terms
Adult, Aged, Brain, Dementia, Diagnosis, Differential, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Prospective Studies, Fluorodeoxyglucose F18, Positron-Emission Tomography

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