A comparison of FDG-PET and blood flow SPECT in the diagnosis of neurodegenerative dementias: a systematic review.
Level 1 - systematic review of randomized trials
Systematic review of diagnostic accuracy and comparative imaging studies
PubMed 24123413 · doi:10.1002/gps.4036
What was done
A systematic review searching MEDLINE through February 2013 for English-language human studies evaluating perfusion SPECT and FDG-PET in the diagnosis of neurodegenerative dementias (Alzheimer's disease, dementia with Lewy bodies, frontotemporal dementia) and mild cognitive impairment, with a focus on direct head-to-head comparisons.
What was found
SPECT studies reported sensitivities of 65% to 85% for Alzheimer's disease diagnosis and specificities of 72% to 87% for other neurodegenerative dementias. PET studies reported sensitivities of 75% to 99% and specificities of 71% to 93%. Direct head-to-head comparisons were few, with some showing equal diagnostic utility and others favoring PET.
Why it matters
Although FDG-PET is widely viewed as superior to perfusion SPECT for dementia differential diagnosis, the comparative empirical evidence directly supporting this preference is limited.
Limits
The abstract does not state the total number of included studies or participants. Head-to-head comparisons were scarce, had small sample sizes, and were limited methodologically by poorly matched control groups. The search was restricted to MEDLINE and English-language publications.
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