Amyloid-PET and 18F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias

Authors

Gaël Chételat
Javier Arbizu
Henryk Barthel
Valentina Garibotto
Ian Law
Silvia Morbelli
Elsmarieke van de Giessen
Federica Agosta
Frederik Barkhof
David J. Brooks
Maria C. Carrillo
Bruno Dubois
Anders M. Fjell
Giovanni B. Frisoni
Oskar Hansson
Karl Herholz
Brian F. Hutton
Clifford R. Jack
Adriaan A. Lammertsma
Susan M. Landau
Satoshi Minoshima
Flavio Nobili
Agneta Nordberg
Rik Ossenkoppele
Wim J. G. Oyen
Daniela Perani
Gil D. Rabinovici
Philip Scheltens
Victor L. Villemagne, Edith Cowan UniversityFollow
Henrik Zetterberg
Alexander Drzezga

Document Type

Journal Article

Publication Title

The Lancet Neurology

ISSN

14744422

Volume

19

Issue

11

First Page

951

Last Page

962

Publisher

Elsevier

School

School of Medical and Health Sciences

RAS ID

35315

Funders

https://www.sciencedirect.com/science/article/pii/S1474442220303148?via%3Dihub

Comments

Chételat, G., Arbizu, J., Barthel, H., Garibotto, V., Law, I., Morbelli, S., ... Drzezga, A. (2020). Amyloid-PET and 18F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias. The Lancet Neurology, 19(11), 951-962. https://doi.org/10.1016/S1474-4422(20)30314-8

Abstract

© 2020 Elsevier Ltd Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and 18F-fluorodeoxyglucose (18F-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information. However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise. We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia. We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and 18F-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation. We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies.

DOI

10.1016/S1474-4422(20)30314-8

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