Title | Clinical Impact of a Second FDG-PET in Atypical/Unclear Dementia Syndromes. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Bergeron, D, Beauregard, J-M, Guimond, J, Fortin, M-P, Houde, M, Poulin, S, Verret, L, Bouchard, RW, Laforce, R |
Journal | J Alzheimers Dis |
Volume | 49 |
Issue | 3 |
Pagination | 695-705 |
Date Published | 2016 |
ISSN | 1875-8908 |
Keywords | Adult, Brain, Dementia, Diagnosis, Differential, Female, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Positron-Emission Tomography, Radiopharmaceuticals, Retrospective Studies |
Abstract | Diagnosis of atypical/unclear dementia is often difficult and this delays treatment initiation. Several authors have shown that beyond standard dementia workup, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) reduces the number of unclear diagnoses, leads to earlier treatment, and has a beneficial impact on families. However, it is not uncommon that the FDG-PET findings are equivocal in this setting. For those cases, a repeat FDG-PET may clarify the diagnosis and prevent treatment delay. We retrospectively assessed the clinical impact of a repeat FDG-PET in 59 patients with atypical/unclear dementia syndromes and inconclusive initial FDG-PET. Changes in primary diagnosis, diagnostic confidence, and management following the second FDG-PET were examined. Conducting a second FDG-PET reduced the number of unclear diagnoses from 80% to 34% , led to diagnostic change in 24% of cases, and treatment modification in 22% of patients. Overall, the clinical impact was higher when initial diagnostic confidence was low and the second FDG-PET repeated ≥12 months after the first one. In tertiary care memory clinic settings, when diagnostic incertitude persists despite extensive evaluation and an equivocal FDG-PET, repeating the FDG-PET 12 months later can greatly clarify the diagnosis and improve management. |
DOI | 10.3233/JAD-150302 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 26484904 |