The Usefulness of <sup>18</sup>F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis
Seunghee Na, Dong Woo Kang, Geon Ha Kim, Ko Woon Kim, Yeshin Kim, Han Jo Kim, Kee Hyung Park, Young Ho Park, Gihwan Byeon, Jeewon Suh, Joon Hyun Shin, YongSoo Shim, YoungSoon Yang, Yoo Hyun Um, Seong‐il Oh, Sheng‐Min Wang, Bora Yoon, Hai‐Jeon Yoon, Sun Min Lee, Juyoun Lee, Jin San Lee, Hak Young Rhee, Jae‐Sung Lim, Young Hee Jung, Juhee Chin, Yun Jeong Hong, Hyemin Jang, Hongyoon Choi, Miyoung Choi, Jae‐Won Jang
Abstract
Background and Purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges.This review examines the effectiveness of 18 F-Fluorodeoxyglucose Positron Emission Tomography ( 18 F-FDG PET) in differentiating these subtypes for precise treatment and management.Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18 F-FDG PET in dementia.The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes.Results: From 12,815 articles, 14 were selected for final analysis.For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98)and specificity was 0.84 (95% CI, 0.70-0.92).In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98)and specificity of 0.92 (95% CI, 0.70-0.92).Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91)and the specificity was 0.88 (95% CI, 0.80-0.91).The studies mostly used case-control designs with visual and quantitative assessments.Conclusions: 18 F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB.This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.