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FDG PET Imaging Evaluation of Neurodegenerative Dementias

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Molecular Imaging of Neurodegenerative Disorders

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Abstract

Brain PET imaging with [F-18]fluorodeoxyglucose (FDG) has been used extensively for research and clinical applications in dementia. Since the invention of FDG in the 1970s and the initial applications to brain disorders, brain FDG PET has unveiled the pathophysiology of neurodegeneration, elucidated altered patterns of glucose metabolism in various dementing disorders, and advanced clinical applications for the evaluation of patients suffering from cognitive impairments. In this chapter, we will discuss: (1) indications of FDG PET in dementia evaluation; (2) image interpretation using statistical mapping technology; (3) pretest probability and referral bias; (4) differential diagnoses of Alzheimer’s disease (AD), frontotemporal dementia (FTD), and Dementia with Lewy bodies (DLB); (5) recognition of subtypes of AD and frontotemporal lobar degeneration (FTLD); (6) FDG PET findings of newly recognized neurodegeneration, Limbic-predominant age-related TDP-43 encephalopathy (LATE); and (7) increasing recognition of mixed dementia and co-pathologies and how FDG PET interpretation needs to evolve. FDG PET imaging remains a valuable tool for the evaluation of dementia owing to its relatively low cost, differential diagnostic performance, widespread availability, and physicians’ experience over more than four decades since the initial development.

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References

  1. Minoshima S, Cross D, Thientunyakit T, Foster NL, Drzezga A. (18)F-FDG PET imaging in neurodegenerative dementing disorders: insights into subtype classification, emerging disease categories, and mixed dementia with copathologies. J Nucl Med. 2022;63:2s–12s.

    Article  CAS  PubMed  Google Scholar 

  2. Guedj E, Varrone A, Boellaard R, et al. EANM procedure guidelines for brain PET imaging using [(18)F]FDG, version 3. Eur J Nucl Med Mol Imaging. 2022;49:632–51.

    Article  PubMed  Google Scholar 

  3. Minoshima S, Frey KA, Koeppe RA, Foster NL, Kuhl DE. A diagnostic approach in Alzheimer’s disease using three-dimensional stereotactic surface projections of Fluorine-18-FDG PET. J Nucl Med. 1995;36:1238–48.

    CAS  PubMed  Google Scholar 

  4. Frisoni GB, Bocchetta M, Chetelat G, et al. Imaging markers for Alzheimer disease: which vs how. Neurology. 2013;81:487–500.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Bours MJ. Bayes' rule in diagnosis. J Clin Epidemiol. 2021;131:158–60.

    Article  PubMed  Google Scholar 

  6. Minoshima S, Mosci K, Cross D, Thientunyakit T. Brain [F-18]FDG PET for clinical dementia workup: differential diagnosis of Alzheimer’s disease and other types of dementing disorders. Semin Nucl Med. 2021;51:230–40.

    Article  PubMed  Google Scholar 

  7. American College of Radiology ACR Appropriateness Criteria. Dementia. https://acsearch.acr.org/docs/3111292/narrative/.

  8. McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium. Neurology. 2017;89:88–100.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Crutch SJ, Lehmann M, Schott JM, Rabinovici GD, Rossor MN, Fox NC. Posterior cortical atrophy. Lancet Neurol. 2012;11:170–8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Yong KXX, Graff-Radford J, Ahmed S, et al. Diagnosis and management of posterior cortical atrophy. Curr Treat Options Neurol. 2023;25:23–43.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Shir D, Graff-Radford J, Machulda MM, et al. Posterior cortical atrophy: primary occipital variant. Eur J Neurol. 2022;29:2138–43.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Whitwell JL, Graff-Radford J, Singh TD, et al. (18)F-FDG PET in posterior cortical atrophy and dementia with Lewy bodies. J Nucl Med. 2017;58:632–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Nedelska Z, Josephs KA, Graff-Radford J, et al. (18) F-Av-1451 uptake differs between dementia with Lewy bodies and posterior cortical atrophy. Mov Disord. 2019;34:344–52.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lehingue E, Gueniat J, Jourdaa S, et al. Improving the diagnosis of the frontal variant of Alzheimer’s disease with the Daphne Scale. J Alzheimers Dis. 2021;79:1735–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Ossenkoppele R, Singleton EH, Groot C, et al. Research criteria for the behavioral variant of Alzheimer disease: a systematic review and meta-analysis. JAMA Neurol. 2021;79(1):48–60.

    Article  PubMed Central  Google Scholar 

  16. Petersen RC, Caracciolo B, Brayne C, Gauthier S, Jelic V, Fratiglioni L. Mild cognitive impairment: a concept in evolution. J Intern Med. 2014;275:214–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. De Leon MJ, Convit A, Wolf OT, et al. Prediction of cognitive decline in normal elderly subjects with 2-[(18)F]fluoro-2-deoxy-D-glucose/positron-emission tomography (FDG/PET). Proc Natl Acad Sci U S A. 2001;98:10966–71.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mosconi L, Perani D, Sorbi S, et al. MCI conversion to dementia and the APOE genotype: a prediction study with FDG-PET. Neurology. 2004;63:2332–40.

    Article  CAS  PubMed  Google Scholar 

  19. Chetelat G, Eustache F, Viader F, et al. FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment. Neurocase. 2005;11:14–25.

    Article  PubMed  Google Scholar 

  20. Drzezga A, Grimmer T, Riemenschneider M, et al. Prediction of individual clinical outcome in mci by means of genetic assessment and (18)F-FDG PET. J Nucl Med. 2005;46:1625–32.

    CAS  PubMed  Google Scholar 

  21. Fellgiebel A, Scheurich A, Bartenstein P, Muller MJ. FDG-PET and CSF phospho-tau for prediction of cognitive decline in mild cognitive impairment. Psychiatry Res. 2007;155:167–71.

    Article  CAS  PubMed  Google Scholar 

  22. Burdette JH, Minoshima S, Vander Borght T, Tran DD, Kuhl DE. Alzheimer disease: improved visual interpretation of PET images by using three-dimensional stereotaxic surface projections. Radiology. 1996;198:837–43.

    Article  CAS  PubMed  Google Scholar 

  23. Nelson PT, Dickson DW, Trojanowski JQ, et al. Limbic-predominant age-related Tdp-43 encephalopathy (late): consensus working group report. Brain. 2019;142:1503–27.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Neumann M, Rademakers R, Roeber S, Baker M, Kretzschmar HA, Mackenzie IR. A new subtype of frontotemporal lobar degeneration with Fus pathology. Brain. 2009;132:2922–31.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Urwin H, Josephs KA, Rohrer J, et al. Fus pathology defines the majority of tau- and Tdp-43-negative frontotemporal lobar degeneration. Acta Neuropathol. 2010;120:33–41.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Boyle PA, Yu L, Wilson RS, Leurgans SE, Schneider JA, Bennett DA. Person-specific contribution of neuropathologies to cognitive loss in old age. Ann Neurol. 2018;83:74–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Mesulam MM, Dickerson BC, Sherman JC, et al. Case 1-2017. A 70-year-old woman with gradually progressive loss of language. N Engl J Med. 2017;376:158–67.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA

    Satoshi Minoshima & Donna J. Cross

  2. Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Tanyaluck Thientunyakit

  3. Department of Nuclear Medicine, Hospital das Forças Armadas (HFA), Brasilia, Distrito Federal, Brazil

    Karina Mosci

Authors
  1. Satoshi Minoshima
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  2. Tanyaluck Thientunyakit
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  3. Donna J. Cross
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  4. Karina Mosci
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Corresponding author

Correspondence to Satoshi Minoshima .

Editor information

Editors and Affiliations

  1. Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA

    Donna J. Cross

  2. Department of Nuclear Medicine, Hospital das Forças Armadas (HFA), Brasilia, Distrito Federal, Brazil

    Karina Mosci

  3. Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA

    Satoshi Minoshima

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Minoshima, S., Thientunyakit, T., Cross, D.J., Mosci, K. (2023). FDG PET Imaging Evaluation of Neurodegenerative Dementias. In: Cross, D.J., Mosci, K., Minoshima, S. (eds) Molecular Imaging of Neurodegenerative Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-35098-6_4

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  • DOI: https://doi.org/10.1007/978-3-031-35098-6_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-35097-9

  • Online ISBN: 978-3-031-35098-6

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