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

Chételat, Gaël ; Arbizu, Javier ; Barthel, Henryk ; Garibotto, Valentina ; Law, Ian ; Morbelli, Silvia ; van de Giessen, Elsmarieke ; Agosta, Federica ; Barkhof, Frederik and Brooks, David J. , et al. (2020) In The Lancet Neurology 19(11). p.951-962
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Lancet Neurology
volume
19
issue
11
pages
12 pages
publisher
Lancet Publishing Group
external identifiers
  • pmid:33098804
  • scopus:85092900781
ISSN
1474-4422
DOI
10.1016/S1474-4422(20)30314-8
language
English
LU publication?
yes
id
a21078b1-2879-44e6-9603-c25a12e5ff86
date added to LUP
2020-11-05 14:33:47
date last changed
2024-04-17 18:41:55
@article{a21078b1-2879-44e6-9603-c25a12e5ff86,
  abstract     = {{<p>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 <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-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 <sup>18</sup>F-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.</p>}},
  author       = {{Chételat, Gaël and Arbizu, Javier and Barthel, Henryk and Garibotto, Valentina and Law, Ian and Morbelli, Silvia and van de Giessen, Elsmarieke and Agosta, Federica and Barkhof, Frederik and Brooks, David J. and Carrillo, Maria C. and Dubois, Bruno and Fjell, Anders M. and Frisoni, Giovanni B. and Hansson, Oskar and Herholz, Karl and Hutton, Brian F. and Jack, Clifford R. and Lammertsma, Adriaan A. and Landau, Susan M. and Minoshima, Satoshi and Nobili, Flavio and Nordberg, Agneta and Ossenkoppele, Rik and Oyen, Wim J.G. and Perani, Daniela and Rabinovici, Gil D. and Scheltens, Philip and Villemagne, Victor L. and Zetterberg, Henrik and Drzezga, Alexander}},
  issn         = {{1474-4422}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{951--962}},
  publisher    = {{Lancet Publishing Group}},
  series       = {{The Lancet Neurology}},
  title        = {{Amyloid-PET and <sup>18</sup>F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias}},
  url          = {{http://dx.doi.org/10.1016/S1474-4422(20)30314-8}},
  doi          = {{10.1016/S1474-4422(20)30314-8}},
  volume       = {{19}},
  year         = {{2020}},
}