title: Diagnostic Accuracy of MRI and Additional [18F]FDG-PET for Behavioral Variant Frontotemporal Dementia in Patients with Late Onset Behavioral Changes.
abstract: Neuroimaging has a reasonable accuracy to differentiate behavioral variant frontotemporal dementia (bvFTD) from other neurodegenerative disorders, its value for the differentiation of bvFTD among subjects with acquired behavioral disturbances is unknown.
  
  
  
  To determine the diagnostic accuracy of MRI, additional [18F]FDG-PET, and their combination for bvFTD among subjects with late onset behavioral changes.
  
  
  
  Patients with late onset behavioral changes referred to a memory clinic or psychiatric services were included. At baseline, 111 patients had a brain MRI scan and 74 patients received an additional [18F]FDG-PET when the MRI was inconclusive. The consensus diagnosis after two-year-follow-up was used as the gold standard to calculate sensitivity and specificity for baseline neuroimaging.
  
  
  
  27 patients had probable/definite bvFTD and 84 patients had a non-bvFTD diagnosis (primary psychiatric diagnosis or other neurological disorders). MRI had a sensitivity of 70% (95% CI 52-85%) with a specificity of 93% (95% CI 86-97%). Additional [18F]FDG-PET had a sensitivity of 90% (95% CI 66-100%) with a specificity of 68% (95% CI 56-79%). The sensitivity of combined neuroimaging was 96% (95% CI 85-100%) with a specificity of 73% (95% CI 63-81%). In 66% of the genetic FTD cases, MRI lacked typical frontotemporal atrophy. 40% of cases with a false positive [18F]FDG-PET scan had a primary psychiatric diagnosis.
  
  
  
  A good diagnostic accuracy was found for MRI and additional [18F]FDG-PET for bvFTD in patients with late onset behavioral changes. Caution with the interpretation of neuroimaging results should especially be taken in cases with a genetic background and in cases with a primary psychiatric differential diagnosis where [18F]FDG-PET is the only abnormal investigation.
authors.affiliation: Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.|Department of Neurology, Haga Ziekenhuis, The Hague, The Netherlands.
authors.forename: Everard G B
authors.initials: EG
authors.lastname: Vijverberg
authors.affiliation: Department of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Mike P
authors.initials: MP
authors.lastname: Wattjes
authors.affiliation: Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands.
authors.forename: Annemiek
authors.initials: A
authors.lastname: Dols
authors.affiliation: Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Welmoed A
authors.initials: WA
authors.lastname: Krudop
authors.affiliation: Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.|Leiden Institute for Brain and Cognition (LIBC), Institute of Psychology, Leiden University, Leiden, The Netherlands.
authors.forename: Christiane
authors.initials: C
authors.lastname: Möller
authors.affiliation: Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Peters
authors.affiliation: Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands.
authors.forename: Cora J
authors.initials: CJ
authors.lastname: Kerssens
authors.affiliation: Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands.
authors.forename: Flora
authors.initials: F
authors.lastname: Gossink
authors.affiliation: Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Niels D
authors.initials: ND
authors.lastname: Prins
authors.affiliation: Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands.
authors.forename: Max L
authors.initials: ML
authors.lastname: Stek
authors.affiliation: Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.affiliation: Department of Nuclear Medicine & PET research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Bart N M
authors.initials: BN
authors.lastname: van Berckel
authors.affiliation: Department of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Yolande A L
authors.initials: YA
authors.lastname: Pijnenburg
mesh_terms: D017668:Age of Onset; D000368:Aged; D001284:Atrophy; D001921:Brain / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D057180:Frontotemporal Dementia / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000000981:diagnostic imaging; D008875:Middle Aged; D059906:Neuroimaging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Behavior; MRI; diagnostic accuracy; frontotemporal dementia; neuropsychology; psychiatric disorders