TY - JOUR
T1 - Amyloid-PET and 18F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias
AU - Chételat, Gaël
AU - Arbizu, Javier
AU - Barthel, Henryk
AU - Garibotto, Valentina
AU - Law, Ian
AU - Morbelli, Silvia
AU - van de Giessen, Elsmarieke
AU - Agosta, Federica
AU - Barkhof, Frederik
AU - Brooks, David J.
AU - Carrillo, Maria C.
AU - Dubois, Bruno
AU - Fjell, Anders M.
AU - Frisoni, Giovanni B.
AU - Hansson, Oskar
AU - Herholz, Karl
AU - Hutton, Brian F.
AU - Jack, Clifford R.
AU - Lammertsma, Adriaan A.
AU - Landau, Susan M.
AU - Minoshima, Satoshi
AU - Nobili, Flavio
AU - Nordberg, Agneta
AU - Ossenkoppele, Rik
AU - Oyen, Wim J. G.
AU - Perani, Daniela
AU - Rabinovici, Gil D.
AU - Scheltens, Philip
AU - Villemagne, Victor L.
AU - Zetterberg, Henrik
AU - Drzezga, Alexander
N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and 18F-fluorodeoxyglucose (18F-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information. However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise. We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia. We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and 18F-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation. We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies.
AB - Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and 18F-fluorodeoxyglucose (18F-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information. However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise. We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia. We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and 18F-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation. We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies.
UR - http://www.scopus.com/inward/record.url?scp=85092900781&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S1474-4422(20)30314-8
DO - https://doi.org/10.1016/S1474-4422(20)30314-8
M3 - Review article
C2 - 33098804
SN - 1474-4422
VL - 19
SP - 951
EP - 962
JO - Lancet neurology
JF - Lancet neurology
IS - 11
ER -