title: Molecular imaging in the diagnosis of Alzheimer's disease and related disorders.
abstract: BACKGROUND
  The diagnosis of Alzheimer's disease (AD) and its related disorders rely on clinical criteria. There is, however, a large clinical overlap between the different neurodegenerative diseases affecting cognition and, frequently, there are diagnostic uncertainties with atypical clinical presentations. Current clinical practices can now regularly use positron emission tomography (PET) and single-photon emission computed tomography (SPECT) molecular imaging to help resolve such uncertainties. The Neurology Group of the French Society of Nuclear Medicine and Federations of Memory, Resources and Research Centers have collaborated to establish clinical guidelines to determine which molecular imaging techniques to use when seeking a differential diagnosis between AD and other neurodegenerative disorders affecting cognition.
  
  
  BACKGROUND
  According to the current medical literature, the potential usefulness of molecular imaging to address the typical clinical criteria in common forms of AD remains modest, as typical AD presentations rarely raise questions of differential diagnoses with other neurodegenerative disorders. However, molecular imaging could be of significant value in the diagnosis of atypical neurodegenerative disorders, including early onset, rapid cognitive decline, prominent non-amnestic presentations involving language, visuospatial, behavioral/executive and/or non-cognitive symptoms in AD, or prominent amnestic presentations in other non-AD dementias.
  
  
  CONCLUSIONS
  The clinical use of molecular imaging should be recommended for assessing cognitive disturbances particularly in patients with early clinical onset (before age 65) and atypical presentations. However, diagnostic tools should always be part of the global clinical approach, as an isolated positive result cannot adequately establish a diagnosis of any neurodegenerative disorder.
authors.affiliation: Department of Neurology, Neuropsychology, University Hospital Timone, 264, rue St-Pierre, 13005 Marseille, France. Electronic address: Lejla.koric@ap-hm.fr.
authors.forename: L
authors.initials: L
authors.lastname: Koric
authors.affiliation: Nuclear Medicine Department, University Hospital Timone, 13005 Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Guedj
authors.affiliation: Nuclear Medicine Department, University Hospital Pitié Salpêtrière, 75013 Paris, France.
authors.forename: M O
authors.initials: MO
authors.lastname: Habert
authors.affiliation: Neuroimaging Department, University Hospital Roger Salengro, 59000 Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Semah
authors.affiliation: Department of Neurology, University Hospital Côte de Nacre, 14000 Caen, France.
authors.forename: P
authors.initials: P
authors.lastname: Branger
authors.affiliation: Department of Nuclear Medicine, Purpan University Hospital, 31059 Toulouse, France.
authors.forename: P
authors.initials: P
authors.lastname: Payoux
authors.affiliation: Nuclear Medicine Department, Centre Eugène Marquis, 35042 Rennes, France.
authors.forename: F
authors.initials: F
authors.lastname: Le Jeune
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D000682:Amyloid / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging; D003704:Dementia / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D057054:Molecular Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D000682:Amyloid
keywords: 18F-FDG-PET imaging; Alzheimer's disease; Amyloid imaging; DaTscan™; MIBG scintigraphy