Dementia and Neurocognitive Disorders (대한치매학회지)

Korean Dementia Association (대한치매학회)
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The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis

  • Seunghee Na (Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Dong Woo Kang (Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Geon Ha Kim (Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine) ;
  • Ko Woon Kim (Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine) ;
  • Yeshin Kim (Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine) ;
  • Hee-Jin Kim (Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University) ;
  • Kee Hyung Park (Department of Neurology, College of Medicine, Gachon University Gil Medical Center) ;
  • Young Ho Park (Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Gihwan Byeon (Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine) ;
  • Jeewon Suh (Department of Neurology, National Medical Center) ;
  • Joon Hyun Shin (Dr Shin's Neurology Clinic) ;
  • YongSoo Shim (Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • YoungSoon Yang (Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine) ;
  • Yoo Hyun Um (Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Seong-il Oh (Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine) ;
  • Sheng-Min Wang (Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Bora Yoon (Department of Neurology, Konyang University Hospital, Konyang University College of Medicine) ;
  • Hai-Jeon Yoon (Department of Nuclear Medicine, Ewha Womans University College of Medicine) ;
  • Sun Min Lee (Department of Neurology, Ajou University Hospital, Ajou University School of Medicine) ;
  • Juyoun Lee (Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Jin San Lee (Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine) ;
  • Hak Young Rhee (Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine) ;
  • Jae-Sung Lim (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Young Hee Jung (Department of Neurology, Myungji Hospital) ;
  • Juhee Chin (Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yun Jeong Hong (Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hyemin Jang (Department of Neurology, Seoul National University Hospital) ;
  • Hongyoon Choi (Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Miyoung Choi (Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency) ;
  • Jae-Won Jang (Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine) ;
  • Korean Dementia Association (Korean Dementia Association)
  • Received : 2024.01.19
  • Accepted : 2024.01.22
  • Published : 2024.01.31
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Abstract

Background and Purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions: 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.

Keywords

Acknowledgement

This study (or guideline) was supported by National Evidence-based Healthcare Collaborating Agency (NA23-014, NA-24-003).

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