[18F]Fluorodeoxyglucose position emission tomography for differential diagnosis of depressive cognitive impairment: incremental value compared with clinical diagnosis.
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| Title: | [18F]Fluorodeoxyglucose position emission tomography for differential diagnosis of depressive cognitive impairment: incremental value compared with clinical diagnosis. |
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| Authors: | Hellwig, Sabine (AUTHOR), Frings, Lars (AUTHOR), Heibel, Meret (AUTHOR), Schroeter, Nils (AUTHOR), Blazhenets, Ganna (AUTHOR), Domschke, Katharina (AUTHOR), Brumberg, Joachim (AUTHOR), Meyer, Philipp T. (AUTHOR) |
| Source: | British Journal of Psychiatry. Apr2026, Vol. 228 Issue 4, p332-339. 8p. |
| Subjects: | Diagnostic imaging, Diagnosis, Cognition disorders, Lewy body dementia, Neurodegeneration, Alzheimer's disease, Differential diagnosis, Biomarkers |
| Abstract: | Background: Assessment of regional glucose metabolism by [18F]fluorodeoxyglucose position emission tomography ([18F]FDG PET) serves as a biomarker for differential diagnosis of dementia. Conversely, depressive cognitive impairment shows no abnormalities on cerebral [18F]FDG PET. Aims: This study validates the diagnostic value of [18F]FDG PET in addition to clinical diagnosis in a real-life gerontopsychiatric clinical population. Method: Ninety-eight consecutive patients with depression and cognitive impairment were included. Baseline clinical diagnoses were independently established before and after disclosure of [18F]FDG PET, and dichotomised into neurodegenerative or non-neurodegenerative diseases (level 1). Subsequently, neurodegenerative cases were allocated to diagnostic subgroups (Alzheimer's disease, Lewy body diseases, frontotemporal lobar degeneration, neurodegenerative other; level 2). An interdisciplinary, biomarker-supported consensus diagnosis after a median follow-up of 6.6 month after [18F]FDG PET served as reference. Changes of clinical diagnoses and diagnostic accuracy were assessed. Results: After disclosure of [18F]FDG PET, level-1 clinical diagnoses changed in 23% (95% CI 16–33%) of cases, improving the diagnostic accuracy from 72% (95% CI 62–81%) to 92% (95% CI 84–96%) (P < 0.001). [18F]FDG PET was of particular value for exclusion of neurodegenerative disease. Concerning level-2 decisions, the clinical diagnoses changed in 30% (95% CI 21–40%) of cases, increasing its accuracy from 64% (95% CI 54–74%) to 85% (95% CI 76–91%) (P < 0.001). A major fraction of incorrect level-2 diagnoses comprised Alzheimer's disease misdiagnosed as Lewy body diseases. Conclusions: [18F]FDG PET provides a significant incremental diagnostic value beyond the clinical diagnosis in depressive cognitive impairment. Thus, [18F]FDG PET should be considered in the diagnostic work-up of patients with mental disorders and cognitive impairment. [ABSTRACT FROM AUTHOR] |
| Copyright of British Journal of Psychiatry is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 192319612 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: [<superscript>18</superscript>F]Fluorodeoxyglucose position emission tomography for differential diagnosis of depressive cognitive impairment: incremental value compared with clinical diagnosis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Hellwig%2C+Sabine%22">Hellwig, Sabine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Frings%2C+Lars%22">Frings, Lars</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Heibel%2C+Meret%22">Heibel, Meret</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schroeter%2C+Nils%22">Schroeter, Nils</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Blazhenets%2C+Ganna%22">Blazhenets, Ganna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Domschke%2C+Katharina%22">Domschke, Katharina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brumberg%2C+Joachim%22">Brumberg, Joachim</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Meyer%2C+Philipp+T%2E%22">Meyer, Philipp T.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22British+Journal+of+Psychiatry%22">British Journal of Psychiatry</searchLink>. Apr2026, Vol. 228 Issue 4, p332-339. 8p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Diagnostic+imaging%22">Diagnostic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Cognition+disorders%22">Cognition disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Lewy+body+dementia%22">Lewy body dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Neurodegeneration%22">Neurodegeneration</searchLink><br /><searchLink fieldCode="DE" term="%22Alzheimer's+disease%22">Alzheimer's disease</searchLink><br /><searchLink fieldCode="DE" term="%22Differential+diagnosis%22">Differential diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Biomarkers%22">Biomarkers</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Assessment of regional glucose metabolism by [18F]fluorodeoxyglucose position emission tomography ([18F]FDG PET) serves as a biomarker for differential diagnosis of dementia. Conversely, depressive cognitive impairment shows no abnormalities on cerebral [18F]FDG PET. Aims: This study validates the diagnostic value of [18F]FDG PET in addition to clinical diagnosis in a real-life gerontopsychiatric clinical population. Method: Ninety-eight consecutive patients with depression and cognitive impairment were included. Baseline clinical diagnoses were independently established before and after disclosure of [18F]FDG PET, and dichotomised into neurodegenerative or non-neurodegenerative diseases (level 1). Subsequently, neurodegenerative cases were allocated to diagnostic subgroups (Alzheimer's disease, Lewy body diseases, frontotemporal lobar degeneration, neurodegenerative other; level 2). An interdisciplinary, biomarker-supported consensus diagnosis after a median follow-up of 6.6 month after [18F]FDG PET served as reference. Changes of clinical diagnoses and diagnostic accuracy were assessed. Results: After disclosure of [18F]FDG PET, level-1 clinical diagnoses changed in 23% (95% CI 16–33%) of cases, improving the diagnostic accuracy from 72% (95% CI 62–81%) to 92% (95% CI 84–96%) (P < 0.001). [18F]FDG PET was of particular value for exclusion of neurodegenerative disease. Concerning level-2 decisions, the clinical diagnoses changed in 30% (95% CI 21–40%) of cases, increasing its accuracy from 64% (95% CI 54–74%) to 85% (95% CI 76–91%) (P < 0.001). A major fraction of incorrect level-2 diagnoses comprised Alzheimer's disease misdiagnosed as Lewy body diseases. Conclusions: [18F]FDG PET provides a significant incremental diagnostic value beyond the clinical diagnosis in depressive cognitive impairment. Thus, [18F]FDG PET should be considered in the diagnostic work-up of patients with mental disorders and cognitive impairment. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of British Journal of Psychiatry is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1192/bjp.2025.67 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 332 Subjects: – SubjectFull: Diagnostic imaging Type: general – SubjectFull: Diagnosis Type: general – SubjectFull: Cognition disorders Type: general – SubjectFull: Lewy body dementia Type: general – SubjectFull: Neurodegeneration Type: general – SubjectFull: Alzheimer's disease Type: general – SubjectFull: Differential diagnosis Type: general – SubjectFull: Biomarkers Type: general Titles: – TitleFull: [18F]Fluorodeoxyglucose position emission tomography for differential diagnosis of depressive cognitive impairment: incremental value compared with clinical diagnosis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Hellwig, Sabine – PersonEntity: Name: NameFull: Frings, Lars – PersonEntity: Name: NameFull: Heibel, Meret – PersonEntity: Name: NameFull: Schroeter, Nils – PersonEntity: Name: NameFull: Blazhenets, Ganna – PersonEntity: Name: NameFull: Domschke, Katharina – PersonEntity: Name: NameFull: Brumberg, Joachim – PersonEntity: Name: NameFull: Meyer, Philipp T. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 00071250 Numbering: – Type: volume Value: 228 – Type: issue Value: 4 Titles: – TitleFull: British Journal of Psychiatry Type: main |
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