The role of brain perfusion SPECT in the diagnosis of frontotemporal dementia: A systematic review

Abstract

Background and PurposeFrontotemporal dementia (FTD) is the second most common cause of presenile dementia. The clinical distinction between FTD, Alzheimer's disease (AD), and other dementias is a clinical challenge. Brain perfusion SPECT may contribute to the diagnosis of FTD, but its value is unclear.MethodsWe performed a systematic review to investigate the diagnostic accuracy of the brain SPECT in (1) distinguishing FTD from AD and other dementias and (2) differentiating FTD variants.ResultsOverall, 391 studies were retrieved on the initial search and 35 studies composed the final selection, comprising a total number of 3142 participants of which 1029 had FTD. The sensitivity and the specificity for the differential diagnosis of FTD versus AD ranged from 56% to 88% and from 51% to 93%, respectively. SPECT is not superior to the clinical method of diagnosis, but the combination of SPECT with clinical data seems to improve the diagnostic accuracy.ConclusionBrain perfusion SPECT has a limited value in the diagnostic framework of FTD. SPECT can be performed when FDG‐PET is not available. SPECT is recommended only for selected cases when the diagnosis is challenging using conventional methods.