Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia

Eur J Nucl Med Mol Imaging. 2018 Jul;45(9):1509-1525. doi: 10.1007/s00259-018-4035-y. Epub 2018 May 7.


Aim: To assess the clinical utility of FDG-PET as a diagnostic aid for differentiating Alzheimer's disease (AD; both typical and atypical forms), dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD) and non-degenerative pseudodementia.

Methods: A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted on six different diagnostic scenarios using the Delphi method.

Results: The level of empirical study evidence for the use of FDG-PET was considered good for the discrimination of DLB and AD; fair for discriminating FTLD from AD; poor for atypical AD; and lacking for discriminating DLB from FTLD, AD from VaD, and for pseudodementia. Delphi voting led to consensus in all scenarios within two iterations. Panellists supported the use of FDG-PET for all PICOs-including those where study evidence was poor or lacking-based on its negative predictive value and on the assistance it provides when typical patterns of hypometabolism for a given diagnosis are observed.

Conclusion: Although there is an overall lack of evidence on which to base strong recommendations, it was generally concluded that FDG-PET has a diagnostic role in all scenarios. Prospective studies targeting diagnostically uncertain patients for assessing the added value of FDG-PET would be highly desirable.

Keywords: Alzheimer’s disease; Atypical Alzheimer; Delphi; Dementia with Lewy bodies; FDG-PET; Frontotemporal lobar degeneration; PICO; Pseudodementia; Vascular dementia.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease
  • Dementia / diagnostic imaging*
  • Diagnosis, Differential
  • Fluorodeoxyglucose F18
  • Humans
  • Lewy Body Disease
  • Positron-Emission Tomography*
  • Prospective Studies


  • Fluorodeoxyglucose F18