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KMID : 1100220240230010054
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Dementia and Neurocognitive Disorders
2024 Volume.23 No. 1 p.54 ~ p.66
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The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis
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Na Seung-Hee
Kang Dong-Woo
Kim Geon-Ha
Kim Ko-Woon
Kim Ye-Shin
Kim Hee-Jin
Park Kee-Hyung
Park Young-Ho
Byeon Gi-Hwan
Suh Jee-Won
Shin Joon-Hyun
Shim Yong-Soo
Yang Young-Soon
Um Yoo-Hyun
Oh Seong-Il
Wang Sheng-Min
Yoon Bo-Ra
Yoon Hai-Jeon
Lee Sun-Min
Lee Ju-Youn
Lee Jin-San
Rhee Hak-Young
Lim Jae-Sung
Jung Young-Hee
Chin Ju-Hee
Hong Yun-Jeong
Jang Hye-Min
Choi Hong-Yoon
Choi Mi-Young
Jang Jae-Won
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Abstract
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Background and Purpose: Dementia subtypes, including Alzheimer’s dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management.
Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes.
Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88?0.98) and specificity was 0.84 (95% CI, 0.70?0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70?0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80?0.91) and the specificity was 0.88 (95% CI, 0.80?0.91). The studies mostly used case-control designs with visual and quantitative assessments.
Conclusions: 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.
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KEYWORD
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Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Dementia, Meta-Analysis, Alzheimer’s Disease, Frontotemporal Dementia, Lewy Body Disease
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