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European Archives of Psychiatry and Clinical Neuroscience

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01-10-2013 | Invited Review

Systematic review of the diagnostic utility of SPECT imaging in dementia

Authors: Jing Ming Yeo, Xuxin Lim, Zubair Khan, Suvankar Pal

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 7/2013

Abstract

Single-photon emission-computed tomography (SPECT) may potentially contribute to the diagnostic work up of patients with neurodegenerative dementia. This systematic review aims to establish the diagnostic utility of ^99mTc-hexamethylpropyleneamine (^99mTc-HMPAO) and ^99mTc-ethylcysteine dimer SPECT in distinguishing between Alzheimer’s disease (AD) and frontotemporal dementia (FTD), AD and vascular dementia (VD), AD and dementia with Lewy bodies (DLB), and AD and normal controls (NC). We searched MEDLINE and Embase databases via OVID for articles from January 1985 to May 2012 and identified additional studies from reviews and references. Of 755 studies, 49 studies met the inclusion and exclusion criteria for this systematic review; AD versus FTD (n = 13), AD versus VD (n = 18), AD versus DLB (n = 5), and AD versus NC (n = 18). We compiled relevant data and graded the studies with an internal and external validity criteria checklist. We pooled the studies with a clinical diagnosis and those using ^99mTc-HMPAO SPECT in a meta-analysis, calculating the pooled weighted sensitivity, specificity, likelihood ratios, and diagnostic odds ratios using DerSimonian–Laird random-effects model. The pooled weighted sensitivity and specificity of ^99mTc-HMPAO-SPECT in distinguishing clinically diagnosed AD from FTD are 79.7 and 79.9 %, respectively, AD from VD are 74.5 and 72.4 %, AD from DLB are 70.2 and 76.2 %, and AD from NC are 76.1 and 85.4 %. SPECT does have diagnostic value, particularly in differentiating Alzheimer’s disease from frontotemporal dementia and normal controls; however, it should not be used in isolation, rather as an adjunct, and interpreted in the context of clinical information and paraclinical test results.

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Title: Systematic review of the diagnostic utility of SPECT imaging in dementia
Authors: Jing Ming Yeo
Xuxin Lim
Zubair Khan
Suvankar Pal
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 7/2013
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-013-0426-z

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Systematic review of the diagnostic utility of SPECT imaging in dementia

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