Clinical Routine FDG-PET Imaging of Suspected Progressive Supranuclear Palsy and Corticobasal Degeneration: A Gatekeeper for Subsequent Tau-PET Imaging?
Publisher DOI
PubMed ID
29973914
Abstract
Background: F-18-fluordeoxyglucose positron emission tomography (FDG-PET) is widely used for discriminative diagnosis of tau-positive atypical parkinsonian syndromes (T+APS). This approach now stands to be augmented with more specific tau tracers. Therefore, we retrospectively analyzed a large clinical routine dataset of FDG-PET images for evaluation of the strengths and limitations of stand-alone FDG-PET. Methods: A total of 117 patients (age 68.4 ± 11.1 y) underwent an FDG-PET exam. Patients were followed clinically for a minimum of one year and their final clinical diagnosis was recorded. FDG-PET was rated visually (positive/negative) and categorized as high, moderate or low likelihood of T+APS and other neurodegenerative disorders. We then calculated positive and negative predictive values (PPV/NPV) of FDG-PET readings for the different subgroups relative to their final clinical diagnosis. Results: Suspected diagnoses were confirmed by clinical follow-up (≥1 y) for 62 out of 117 (53%) patients. PPV was excellent when FDG-PET indicated a high likelihood of T+APS in combination with low to moderate likelihood of another neurodegenerative disorder. PPV was distinctly lower when FDG-PET indicated only a moderate likelihood of T+APS or when there was deemed equal likelihood of other neurodegenerative disorder. NPV of FDG-PET with a low likelihood for T+APS was high. Conclusions: FDG-PET has high value in clinical routine evaluation of suspected T+APS, gaining satisfactory differential diagnosis in two thirds of the patients. One third of patients would potentially profit from further evaluation by more specific radioligands, with FDG-PET serving gatekeeper function for the more expensive methods.
Date Issued
2018-06-20
Publication Type
Article
Subject(s)
Subjects
F-18-FDG
•
PET
•
atypical parkinsonian syndrome
•
clinical routine
•
corticobasal degeneration
•
progressive supranuclear palsy
Language(s)
en
Author(s)
Beyer, Leonie | |
Meyer-Wilmes, Johanna | |
Schönecker, Sonja | |
Schnabel, Jonas | |
Brendel, Eva | |
Prix, Catharina | |
Nübling, Georg | |
Unterrainer, Marcus | |
Albert, Nathalie L. | |
Pogarell, Oliver | |
Perneczky, Robert | |
Catak, Cihan | |
Bürger, Katharina | |
Bartenstein, Peter | |
Bötzel, Kai | |
Levin, Johannes | |
Brendel, Matthias |
Additional Credits
Journal
Frontiers in neurology
Publisher
Frontiers Media S.A.
ISSN
1664-2295
Access(Rights)
open.access