A Cochrane review on brain [(1)(8)F]FDG PET in dementia: limitations and future perspectives(124 visite) Morbelli S, Garibotto V, Van De Giessen E, Arbizu J, Chetelat G, Drezgza A, Hesse S, Lammertsma AA, Law I, Pappata S, Payoux P, Pagani M
*** IBB - CNR *** 1 Nuclear Medicine Unit, IRCCS San Martino - IST, Department of Health Sciences, University of Genoa, Largo R. Benzi 10, 2 Department of Medical Imaging, Geneva University and Geneva University Hospitals, Geneva, Switzerland 3 Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 4 Nuclear Medicine Department, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain 5 Inserm, U1077, Caen, France 6 Université de Caen Basse-Normandie, UMR-S1077, Caen, France 7 Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France 8 CHU de Caen, U1077, Caen, France Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln, 10 Department of Nuclear Medicine, University of Leipzig, 11 Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands 12 Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, 13 Institute of Biostructure and Bioimaging, CNR, Naples, Italy 14 INSERM UMR 825 Université de Toulouse; UPS; Imagerie cérébrale et handicaps neurologiques; CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France 15 Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy 16 Department of Nuclear Medicine, Karolinska Hospital,
[18F]FDG PET is a well-established method for the evaluation<br>of patients with suspected Alzheimer's disease (AD) and other<br>neurodegenerative diseases . This tool has the unique ability<br>to estimate the local cerebral metabolic rate of glucose<br>consumption (CMRgl), thus providing information on the distribution<br>of neuronal death and synapse dysfunction in vivo<br>. Clinically, [18F]FDG PET plays a major role in the early<br>and differential diagnosis of dementia due to AD by showing<br>specific disease patterns of hypometabolism, reflecting neuronal<br>dysfunction in affected brain regions even in the earliest<br>stages of the disease . However, the role of [18F]FDG PET<br>in identifying patients affected by AD but who are still at the<br>stage of mild cognitive impairment (MCI) is less established.<br>Although various studies have indicated a high predictive value<br>in this population, appropriate standardization approaches<br>(i.e. semiquantification methods, observer-independent analyses,<br>identification of cut-off values) and the value of [18F]FDG<br>PET in comparison to amyloidosis biomarkers are still a matter<br>of debate.<br>Recently, a Cochrane review was published with the objective<br>of determining the diagnostic accuracy of [18F]FDG PET<br>for identifying subjects with MCI who will clinically convert<br>toADor other dementias . The authors concluded that there<br>is no evidence supporting routine clinical use of [18F]FDG<br>PET to identify those patients with MCI who will develop<br>AD. For several reasons, we do not agree with the authors of<br>this Cochrane review that existing data on the value of FDG<br>PET in MCI supports such a categorical conclusion. Indeed,<br>clear variability in diagnostic performance of [18F]FDG PET<br>is found in the literature, as correctly reported in the Cochrane<br>review. This variability, however, is not exclusively attributable<br>to the method itself, but rather can be explained by a<br>number of factors concerning study design, definitions of<br>MCI itself and data analysis procedures.<br>We would like to highlight some of these factors in greater<br>detail, because we believe that knowledge on these issues may<br>be necessary to correctly interpret the available literature and<br>to appreciate the diagnostic value of [18F]FDG PET in MCI.
22 Records (19 escludendo Abstract e Conferenze). Impact factor totale: 91.934 (84.979 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 100.306 (90.247 escludendo Abstract e Conferenze).