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lüll FDG-PET improves accuracy in distinguishing frontotemporal dementia and Alzheimer s disease Foster NL; Heidebrink JL; Clark CM; Jagust WJ; Arnold SE; Barbas NR; DeCarli CS; Turner RS; Koeppe RA; Higdon R; Minoshima SBrain 2007[Oct]; 130 (Pt 10): 2616-35Distinguishing Alzheimer's disease (AD) and frontotemporal dementia (FTD) currently relies on a clinical history and examination, but positron emission tomography with [(18)F] fluorodeoxyglucose (FDG-PET) shows different patterns of hypometabolism in these disorders that might aid differential diagnosis. Six dementia experts with variable FDG-PET experience made independent, forced choice, diagnostic decisions in 45 patients with pathologically confirmed AD (n = 31) or FTD (n = 14) using five separate methods: (1) review of clinical summaries, (2) a diagnostic checklist alone, (3) summary and checklist, (4) transaxial FDG-PET scans and (5) FDG-PET stereotactic surface projection (SSP) metabolic and statistical maps. In addition, we evaluated the effect of the sequential review of a clinical summary followed by SSP. Visual interpretation of SSP images was superior to clinical assessment and had the best inter-rater reliability (mean kappa = 0.78) and diagnostic accuracy (89.6%). It also had the highest specificity (97.6%) and sensitivity (86%), and positive likelihood ratio for FTD (36.5). The addition of FDG-PET to clinical summaries increased diagnostic accuracy and confidence for both AD and FTD. It was particularly helpful when raters were uncertain in their clinical diagnosis. Visual interpretation of FDG-PET after brief training is more reliable and accurate in distinguishing FTD from AD than clinical methods alone. FDG-PET adds important information that appropriately increases diagnostic confidence, even among experienced dementia specialists.|Adult[MESH]|Aged[MESH]|Alzheimer Disease/diagnosis/diagnostic imaging[MESH]|Brain/*diagnostic imaging[MESH]|Dementia/diagnosis/*diagnostic imaging[MESH]|Diagnosis, Differential[MESH]|Disease Progression[MESH]|Female[MESH]|Fluorodeoxyglucose F18[MESH]|Humans[MESH]|Image Processing, Computer-Assisted/methods[MESH]|Male[MESH]|Middle Aged[MESH]|Observer Variation[MESH]|Positron-Emission Tomography[MESH]|Radiopharmaceuticals[MESH]|Sensitivity and Specificity[MESH] |