A comparison of FDG-PET and blood flow SPECT in the diagnosis of neurodegenerative dementias: a systematic review
Article first published online: 9 OCT 2013
Copyright © 2013 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 29, Issue 6, pages 551–561, June 2014
How to Cite
Davison, C. M. and O'Brien, J. T. (2014), A comparison of FDG-PET and blood flow SPECT in the diagnosis of neurodegenerative dementias: a systematic review. Int. J. Geriat. Psychiatry, 29: 551–561. doi: 10.1002/gps.4036
- Issue published online: 5 MAY 2014
- Article first published online: 9 OCT 2013
- Manuscript Accepted: 16 SEP 2013
- Manuscript Received: 15 MAY 2013
- National Institute for Health Research (NIHR). Grant Number: NIHR RfPB PB-PG-1207-13105
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease
- Biomedical Research Unit in Lewy Body Dementia
- Biomedical Research Centre and Unit in Dementia
- mild cognitive impairment;
- single photon emission computed tomography;
- positron emission tomography
Perfusion single photon emission computed tomography (SPECT) and 18F fluorodeoxyglucose positron emission tomography (FDG-PET) both have clinical utility for the differential diagnosis of dementia. Although PET is often viewed by some as more accurate and therefore preferential, the extent to which published evidence supports this is not clear.
The aim of this review was to address the question by reviewing studies of SPECT and PET imaging in dementia diagnosis, with a particular focus on all published head-to-head studies.
A MEDLINE search was carried out using the following keywords: “PET” and “SPECT” and “dementia” or “Mild Cognitive Impairment,” together with “alzheimers” or “DLB” or “lewy body” or “frontotemporal” or “FTD” or “Picks.” Articles were included up to February 2013, limited to human studies and in English language.
Published studies of SPECT accuracy show that it is a useful tool for differential diagnosis, with sensitivities of 65–85% for diagnosing Alzheimer's disease (AD) and specificities (for other neurodegenerative dementias) of 72–87%. PET studies generally report higher accuracy, with sensitivities of 75–99% for AD and specificities of 71–93%. However, there have been few direct head-to-head comparisons, with some indicating SPECT and PET to be equally useful in dementia diagnosis and others favouring PET. Many of these studies are limited with respect to numbers and methodically with poorly matched control groups.
Overall, although studies suggest superiority of PET over SPECT, the evidence base for this is actually quite limited. We suggest that further direct comparative studies, including health economic and patient preference evaluations, are needed to help direct future service provision. Copyright © 2013 John Wiley & Sons, Ltd.