[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] |
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| Database: | Psychology and Behavioral Sciences Collection |
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