[Diagnostic usefulness of brain FDG-PET for Alzheimer's dementia]

Ryu YH, Choi JE, Sohn BK, Lyoo CH, Sohn CH, Lee DY, Shin E, Jeong H, Kim H, Kim JY, Shin JH, Lee JY, Byun MS, Lee S, Park SH, Son SK, Choe YM, Lee YE, Kim YK, Lee YK
Record ID 32014001104
Korean
Authors' recommendations: We assessed the diagnostic accuracy of FDG-PET in the evaluation of dementia, which is known as a tool for detecting reduced glucose metabolism in a patient's brain even before the development of dementia symptoms. To evaluate diagnostic accuracy in the early detection of dementia and Alzheimer's disease, we conducted systematic reviews of published articles, and identified 9 cross-sectional studies and 13 delayed cross-sectional studies. In addition, we collected information from the medical charts of amnestic mild cognitive impairment (MCI) patients in a study site and followed them up for two years retrospectively. We then evaluated the diagnostic accuracy of FDG-PET with MRI. Meta-analysis of the 9 cross-sectional studies resulted in a pooled sensitivity (SN) of 0.61 (95% CI:0.42-0.79), a pooled specificity (SP) of 0.81 (95% CI: 0.55-1.07). In the 13 delayed cross-section studies, it resulted in a pooled SN of 0.81 (95% CI: 0.72-0.91) and a pooled SP of 0.78 (95% CI: 0.65-0.92). With subgroup analyses in amnestic mild cognitive impairment (MCI) patients, the result suggested a pooled SN of 0.92 (95% CI: 0.75-1.00), a pooled SP of 0.88 (95% CI: 0.77-0.98). In the outcome analysis of the retrospective cohort, MRI resulted in an SN of 0.37 (95% CI: 0.19-0.59), an SP of 0.69 (95% CI: 0.52-0.81), and an accuracy of 0.57 (95% CI: 0.44-0.71) with an area under the curve (AUC) of 0.53 (95% CI: 0.39-0.66), whereas FDG-PET showed an SN of 0.79 (95% CI: 0.19-0.59), an SP of 0.60 (95% CI: 0.44-0.74), and an accuracy of 0.67 (95% CI: 0.54-0.79) with an AUC of 0.68 (95% CI: 0.56-0.79). In conclusion, we found that the pooled estimate of sensitivity (SN) and specificity (SP) of FDG-PET was the highest among amnestic MCI patients in the systematic analysis. In addition, MRI and FDG-PET may complement each other depending on the characteristics of the target population.
Details
Project Status: Completed
Year Published: 2014
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: South Korea
MeSH Terms
  • Alzheimer Disease
  • Early Diagnosis
  • Fluorodeoxyglucose F18
  • Positron-Emission Tomography
Contact
Organisation Name: National Evidence-based healthcare Collaborating Agency
Contact Address: National Evidence-based Healthcare Collaborating Agency (NECA), 3~5F Health and Welfare Social Administration B/D, 400 Neungdong-ro, Gwangjin-gu, Seoul, Korea.
Contact Name: int@neca.re.kr
Contact Email: int@neca.re.kr
Copyright: National Evidence-based Healthcare Collaborating Agency (NECA)
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