title: Differential diagnosis of neurodegenerative dementias using metabolic phenotypes on F-18 FDG PET/CT.
abstract: Positron emission tomography (PET) imaging with F-18 fluorodeoxyglucose (FDG) can be used as a downstream marker of neuronal injury, a hallmark of neurodegenerative dementias. Characteristic patterns of regional glucose metabolism have been used to classify the dementia subtypes, namely Alzheimer's dementia (AD), frontotemporal dementia (FTD), diffuse Lewy body (DLBD) and vascular dementia (VD). We undertook this study to assess the utility of FDG-PET in the differential diagnosis of dementia subtypes. One hundred and twenty-five patients diagnosed with dementia were referred from cognitive disorders and memory clinics of speciality neurology centres for the FDG-PET study. Imaging-based diagnosis of dementia type was established in 101 patients by visual assessment of individual scans by a PET physician blinded to the clinical diagnosis. The results were compared with an 18-month follow-up clinical assessment made by the specialist neurologist. Concordance of visual evaluation of FDG-PET scans with clinical diagnosis of the dementia type was achieved in 90% of patients scanned. This concordance was 93.4% for AD, 88.8% for FTD, 66.6% for DLBD and 92.3% for the other dementia syndromes. FDG-PET performed after the initial work-up of dementias is useful for supporting the clinical diagnosis of dementia subtype.
authors.affiliation: AIIMS, All India Institute of Medical Sciences; New Delhi, Delhi, India - madhu_deven@yahoo.com.
authors.forename: Madhavi
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: AIIMS, All India Institute of Medical Sciences; New Delhi, Delhi, India.
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: AIIMS, All India Institute of Medical Sciences; New Delhi, Delhi, India.
authors.forename: Nishikant
authors.initials: N
authors.lastname: Damle
authors.affiliation: IHBAS, Institute of Human Behaviour and Allied Sciences; New Delhi, Delhi, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Kushwaha
authors.affiliation: INMAS, Institute of Nuclear Medicine & Allied Sciences; Timarpur, Delhi, India.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Jaimini
authors.affiliation: INMAS, Institute of Nuclear Medicine & Allied Sciences; Timarpur, Delhi, India.
authors.forename: Maria M
authors.initials: MM
authors.lastname: D'Souza
authors.affiliation: INMAS, Institute of Nuclear Medicine & Allied Sciences; Timarpur, Delhi, India.
authors.forename: Rajnish
authors.initials: R
authors.lastname: Sharma
authors.affiliation: INMAS, Institute of Nuclear Medicine & Allied Sciences; Timarpur, Delhi, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Saw
authors.affiliation: INMAS, Institute of Nuclear Medicine & Allied Sciences; Timarpur, Delhi, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Mondal
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000378:metabolism; D007562:Creutzfeldt-Jakob Syndrome / Q000000981:diagnostic imaging / Q000378:metabolism; D003704:Dementia / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000523:psychology; D015140:Dementia, Vascular / Q000000981:diagnostic imaging / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D057180:Frontotemporal Dementia / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism; D009483:Neuropsychological Tests; D010641:Phenotype; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000378:metabolism*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: AD; DLBD; FDG-PET; FTD; vascular dementia