European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain <sup>18</sup>F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

Nobili, Flavio; Arbizu, Javier; Bouwman, Femke H.; Drzezga, Alexander; Agosta, Federica; Nestor, Peter J.; Walker, Zuzana; Boccardi, Marina; Festari, Cristina; Altomare, Daniele; Gandolfo, Federica; Orini, Stefania

doi:10.1111/ene.13728

Cited by 168 publications

(199 citation statements)

References 117 publications

(220 reference statements)

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“…35,49 The present study improves our understanding of pathophysiology and clinical-imaging correlation in DLB, paving the path toward optimization of the use of FDG PET in this clinical setting. Recently, the joined recommendations of the European Academy of Neurology and of the EANM have defined FDG PET as a highly relevant tool in clinical practice, allowing discernment of different patterns of hypometabolism among the main neurodegenerative diseases from prodromal stages, including DLB.…”

Section: Discussionmentioning

confidence: 79%

“…Recently, the joined recommendations of the European Academy of Neurology and of the EANM have defined FDG PET as a highly relevant tool in clinical practice, allowing discernment of different patterns of hypometabolism among the main neurodegenerative diseases from prodromal stages, including DLB. 35,49 The present study improves our understanding of pathophysiology and clinical-imaging correlation in DLB, paving the path toward optimization of the use of FDG PET in this clinical setting.…”

Section: Discussionmentioning

confidence: 79%

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Metabolic patterns across core features in dementia with lewy bodies

Morbelli

Chincarini

Brendel

et al. 2019

Annals of Neurology

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Objective: To identify brain regions whose metabolic impairment contributes to dementia with Lewy bodies (DLB) clinical core features expression and to assess the influence of severity of global cognitive impairment on the DLB hypometabolic pattern. Methods: Brain fluorodeoxyglucose positron emission tomography and information on core features were available in 171 patients belonging to the imaging repository of the European DLB Consortium. Principal component analysis was applied to identify brain regions relevant to the local data variance. A linear regression model was applied to generate core-feature-specific patterns controlling for the main confounding variables (Mini-Mental State Examination [MMSE], age, education, gender, and center). Regression analysis to the locally normalized intensities was performed to generate an MMSE-sensitive map. Results: Parkinsonism negatively covaried with bilateral parietal, precuneus, and anterior cingulate metabolism; visual hallucinations (VH) with bilateral dorsolateral-frontal cortex, posterior cingulate, and parietal metabolism; and rapid eye movement sleep behavior disorder (RBD) with bilateral parieto-occipital cortex, precuneus, and ventrolateral-frontal View this article online at wileyonlinelibrary.com.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 79%

Metabolic patterns across core features in dementia with lewy bodies

Morbelli

Chincarini

Brendel

et al. 2019

Annals of Neurology

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“…Brain magnetic resonance imaging (MRI) should be performed at baseline for exclusionary but also inclusionary purposes (assess medial temporal atrophy or other abnormalities). MRI should be prescribed by the dementia expert, acquired with a standard acquisition protocol High variability of potential clinical impact in this age range Prescription of CSF examination not necessary over 85 R-IV, 5-0-0 Additional information usually has limited clinical impact at older ages Inconsistency between clinical and MRI data Prescribe both CSF [14] and FDG-PET [11] R-IV, 4-1-0 When MRI is negative, FDG-PET can provide evidence of synaptic dysfunction denoting neurodegeneration (see Table S3) and assessed in expert centres or by adequately trained specialists. MRI provides accurate information, even at prodromal stage, on degeneration, vascularity or features typical of less common disorders, e.g.…”

Section: Baseline General Assessment (T0)mentioning

confidence: 99%

Italian consensus recommendations for a biomarker‐based aetiological diagnosis in mild cognitive impairment patients

Boccardi

Nicolosi

Festari

et al. 2019

Euro J of Neurology

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Background and purpose Biomarkers support the aetiological diagnosis of neurocognitive disorders in vivo. Incomplete evidence is available to drive clinical decisions; available diagnostic algorithms are generic and not very helpful in clinical practice. The aim was to develop a biomarker‐based diagnostic algorithm for mild cognitive impairment patients, leveraging on knowledge from recognized national experts. Methods With a Delphi procedure, experienced clinicians making variable use of biomarkers in clinical practice and representing five Italian scientific societies (neurology – Società Italiana di Neurologia per le Demenze; neuroradiology – Associazione Italiana di Neuroradiologia; biochemistry – Società Italiana di Biochimica Clinica; psychogeriatrics – Associazione Italiana di Psicogeriatria; nuclear medicine – Associazione Italiana di Medicina Nucleare) defined the theoretical framework, relevant literature, the diagnostic issues to be addressed and the diagnostic algorithm. An N–1 majority defined consensus achievement. Results The panellists chose the 2011 National Institute on Aging and Alzheimer's Association diagnostic criteria as the reference theoretical framework and defined the algorithm in seven Delphi rounds. The algorithm includes baseline clinical and cognitive assessment, blood examination, and magnetic resonance imaging with exclusionary and inclusionary roles; dopamine transporter single‐photon emission computed tomography (if no/unclear parkinsonism) or metaiodobenzylguanidine cardiac scintigraphy for suspected dementia with Lewy bodies with clear parkinsonism (round VII, votes (yes‐no‐abstained): 3‐1‐1); 18F‐fluorodeoxyglucose positron emission tomography for suspected frontotemporal lobar degeneration and low diagnostic confidence of Alzheimer’s disease (round VII, 4‐0‐1); cerebrospinal fluid for suspected Alzheimer’s disease (round IV, 4‐1‐0); and amyloid positron emission tomography if cerebrospinal fluid was not possible/accepted (round V, 4‐1‐0) or inconclusive (round VI, 5‐0‐0). Conclusions These consensus recommendations can guide clinicians in the biomarker‐based aetiological diagnosis of mild cognitive impairment, whilst guidelines cannot be defined with evidence‐to‐decision procedures due to incomplete evidence.

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“…In the most recent European Association of Nuclear Medicine (EANM) and European Academy of Neurology (EAN) recommendations for the use of brain FDG PET in neurodegenerative cognitive impairment and dementia, the panel agreed on recommending 18 F-FDG PET in diagnosing MCI due to AD, FTLD or DLB, in the diagnosis of atypical AD and pseudodementia, and in differentiating between AD and DLB, FTLD or VD, and between DLB and FTLD [66].…”

Section: Ad Vs Vdmentioning

confidence: 99%

Positron emission tomography neuroimaging in neurodegenerative diseases: Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis

Barć

Kuźma‐Kozakiewicz

2019

Neurol Neurochir Pol.

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Neurodegenerative diseases are a growing problem of ageing societies. Their insidious onset, and the lack of reliable biomarkers, result in significant diagnosis delays. This article summarises the results of studies on the use of positron emission tomography (PET) in the diagnosis of Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. It focuses on clinical-pathogenetic aspects of individual diseases, as well as disease-specific patterns relevant in differential diagnosis and in assessing the risk of disease development and prognosis.

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European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

Abstract: Despite limited formal evidence, panellists deemed FDG-PET useful in the early and differential diagnosis of the main neurodegenerative disorders, and semi-automated assessment helpful to assist visual reading. These decisions are proposed as interim recommendations.

Cited by 168 publications

References 117 publications

Metabolic patterns across core features in dementia with lewy bodies

Metabolic patterns across core features in dementia with lewy bodies

Italian consensus recommendations for a biomarker‐based aetiological diagnosis in mild cognitive impairment patients

Positron emission tomography neuroimaging in neurodegenerative diseases: Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis

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European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain 18F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus

Abstract: Despite limited formal evidence, panellists deemed FDG-PET useful in the early and differential diagnosis of the main neurodegenerative disorders, and semi-automated assessment helpful to assist visual reading. These decisions are proposed as interim recommendations.

Cited by 168 publications

References 117 publications

Metabolic patterns across core features in dementia with lewy bodies

Metabolic patterns across core features in dementia with lewy bodies

Italian consensus recommendations for a biomarker‐based aetiological diagnosis in mild cognitive impairment patients

Positron emission tomography neuroimaging in neurodegenerative diseases: Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis

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Product

Resources

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European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain ¹⁸F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus