Year: 2005
Type: article
Abstract: Positron emission tomography with 18-F-fluorodeoxyglucose (FDG-PET) is a molecular imaging method that provides clinicians unique information about the location and severity of neuronal and synaptic loss in dementing diseases. Alzheimer's disease (AD) and other dementias cause distinctive changes in glucose metabolism that can be exploited to aid diagnosis and treatment decisions. Medicare and other insurers have recently decided to reimburse FDG-PET for the specific indication of distinguishing AD from frontotemporal dementia (FTD). Review strategies to best use FDG-PET in the evaluation and management of dementia. Review of theliterature and presentation of illustrative case examples. Using FDG-PET is particularly useful in deciding whether a patient has AD or FTD. These two disorders can share similar symptoms, but have contrasting patterns of hypometabolism: AD causes abnormalities predominantly in posterior temporoparietal cortex and posterior cingulate gyrus, while in FTD they are most evident in frontal and anterior temporal regions. Recent studies have indicated that visual interpretation of FDG-PET images can be reliable after training and highly accurate when compared to autopsy findings. Clinicians need to be aware of the limitations of this imaging technique. FDG-PET cannot determine whether a patient has dementia; this only can be determined reliably with a clinical evaluation that includes an assessment of mental status and functional abilities. FDG-PET also has not been validated to determine individual future risk of dementia, even though changes have been identified in groups at increased risk of AD. Furthermore, scan findings must be interpreted with full consideration of many technical factors that can affect scan results, and the findings on clinical examination and structural imaging studies. Many other potential applications of FDG-PET currently are being evaluated and offer the hope that it can further improve physician confidence and accuracy in dementia diagnosis.
Source: Alzheimer s & Dementia
Author: Norman L. Foster
Institution: University of Michigan
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2055389458