18F-FDG PET 在区分痴呆症亚型方面的用途:系统综述与元分析》。

Dementia and neurocognitive disorders Pub Date : 2024-01-01 Epub Date: 2024-01-31 DOI:10.12779/dnd.2024.23.1.54
Seunghee Na, Dong Woo Kang, Geon Ha Kim, Ko Woon Kim, Yeshin Kim, Hee-Jin Kim, Kee Hyung Park, Young Ho Park, Gihwan Byeon, Jeewon Suh, Joon Hyun Shin, YongSoo Shim, YoungSoon Yang, Yoo Hyun Um, Seong-Il Oh, Sheng-Min Wang, Bora Yoon, Hai-Jeon Yoon, Sun Min Lee, Juyoun Lee, Jin San Lee, Hak Young Rhee, Jae-Sung Lim, Young Hee Jung, Juhee Chin, Yun Jeong Hong, Hyemin Jang, Hongyoon Choi, Miyoung Choi, Jae-Won Jang
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引用次数: 0

摘要

背景和目的:包括阿尔茨海默氏症痴呆(AD)、路易体痴呆(DLB)和额颞叶痴呆(FTD)在内的痴呆亚型给诊断带来了挑战。本综述探讨了 18F-FDG 正电子发射断层扫描(18F-FDG PET)在区分这些亚型以进行精确治疗和管理方面的有效性:根据《系统综述和元分析首选报告项目》指南,利用 PubMed 和 Embase 等数据库进行了系统综述,以确定有关 18F-FDG PET 在痴呆症诊断中的效用的研究。检索包括截至2022年11月16日的研究,重点关注同行评审期刊,并采用痴呆亚型的金标准临床诊断:结果:从12815篇文章中筛选出14篇进行最终分析。AD相对于FTD的敏感性为0.96(95%置信区间[CI],0.88-0.98),特异性为0.84(95%置信区间,0.70-0.92)。在AD与DLB的比较中,18F-FDG PET的灵敏度为0.93(95% CI为0.88-0.98),特异性为0.92(95% CI为0.70-0.92)。最后,在区分AD和非AD痴呆症时,灵敏度为0.86(95% CI,0.80-0.91),特异性为0.88(95% CI,0.80-0.91)。这些研究大多采用病例对照设计,并进行了视觉和定量评估:结论:18F-FDG PET 在区分痴呆亚型,尤其是 AD、FTD 和 DLB 方面具有很高的灵敏度和特异性。这种方法虽然不是独立的诊断工具,但能显著提高不确定病例的诊断准确性,是对临床评估和结构成像的补充。
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The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis.

Background and purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management.

Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes.

Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments.

Conclusions: 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.

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