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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-07-2018 | Guidelines

Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia

Authors: Femke Bouwman, Stefania Orini, Federica Gandolfo, Daniele Altomare, Cristina Festari, Federica Agosta, Javier Arbizu, Alexander Drzezga, Peter Nestor, Flavio Nobili, Zuzana Walker, Silvia Morbelli, Marina Boccardi, for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2018

Abstract

Purpose

A joint effort of the European Association of Nuclear Medicine (EANM) and the European Academy of Neurology (EAN) aims at clinical guidance for the use of FDG-PET in neurodegenerative diseases. This paper addresses the diagnostic utility of FDG-PET over clinical/neuropsychological assessment in the differentiation of the three forms of primary progressive aphasia (PPA).

Methods

Seven panelists were appointed by the EANM and EAN and a literature search was performed by using harmonized PICO (Population, Intervention, Comparison, Outcome) question keywords. The studies were screened for eligibility, and data extracted to assess their methodological quality. Critical outcomes were accuracy indices in differentiating different PPA clinical forms. Subsequently Delphi rounds were held with the extracted data and quality assessment to reach a consensus based on both literature and expert opinion.

Results

Critical outcomes for this PICO were available in four of the examined papers. The level of formal evidence supporting clinical utility of FDG-PET in differentiating among PPA variants was considered as poor. However, the consensual recommendation was defined on Delphi round I, with six out of seven panelists supporting clinical use.

Conclusions

Quantitative evidence demonstrating utility or lack thereof is still missing. Panelists decided consistently to provide interim support for clinical use based on the fact that a typical atrophy or metabolic pattern is needed for PPA according to the diagnostic criteria, and the synaptic failure detected by FDG-PET is an earlier phenomenon than atrophy. Also, a normal FDG-PET points to a non-neurodegenerative cause.

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Title: Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia
Authors: Femke Bouwman
Stefania Orini
Federica Gandolfo
Daniele Altomare
Cristina Festari
Federica Agosta
Javier Arbizu
Alexander Drzezga
Peter Nestor
Flavio Nobili
Zuzana Walker
Silvia Morbelli
Marina Boccardi
for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-4034-z

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Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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