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Original Article
Dementia and Neurocognitive Disorders 2024: 23: 1: 54-66

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The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis
Seunghee Na , 1 Dong Woo Kang , 2 Geon Ha Kim , 3 Ko Woon Kim , 4 Yeshin Kim , 5 Hee-Jin Kim , 6 Kee Hyung Park , 7 Young Ho Park , 8 Gihwan Byeon , 9 Jeewon Suh , 10 Joon Hyun Shin , 11 YongSoo Shim , 12 YoungSoon Yang , 13 Yoo Hyun Um , 14 Seong-il Oh , 15 Sheng-Min Wang , 16 Bora Yoon , 17 Hai-Jeon Yoon , 18 Sun Min Lee , 19 Juyoun Lee , 20 Jin San Lee , 15 Hak Young Rhee , 21 Jae-Sung Lim , 22 Young Hee Jung , 23 Juhee Chin , 24 Yun Jeong Hong , 25 Hyemin Jang , 26 Hongyoon Choi , 27 Miyoung Choi , 28 Jae-Won Jang 5 , on behalf of Korean Dementia Association
1 Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea 2 Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 3 Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea 4 Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea 5 Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea 6 Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea 7 Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea 8 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea 9 Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea 10Department of Neurology, National Medical Center, Seoul, Korea 11Dr Shin’s Neurology Clinic, Wonju, Korea 12Department of Neurology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 13Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea 14Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea 15Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea 16Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 17Department of Neurology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea 18Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea 19Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea 20Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea 21Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea 22Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 23Department of Neurology, Myungji Hospital, Goyang, Korea 24Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 25Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea 26Department of Neurology, Seoul National University Hospital, Seoul, Korea 27Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea 28Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis
Seunghee Na , 1 Dong Woo Kang , 2 Geon Ha Kim , 3 Ko Woon Kim , 4 Yeshin Kim , 5 Hee-Jin Kim , 6 Kee Hyung Park , 7 Young Ho Park , 8 Gihwan Byeon , 9 Jeewon Suh , 10 Joon Hyun Shin , 11 YongSoo Shim , 12 YoungSoon Yang , 13 Yoo Hyun Um , 14 Seong-il Oh , 15 Sheng-Min Wang , 16 Bora Yoon , 17 Hai-Jeon Yoon , 18 Sun Min Lee , 19 Juyoun Lee , 20 Jin San Lee , 15 Hak Young Rhee , 21 Jae-Sung Lim , 22 Young Hee Jung , 23 Juhee Chin , 24 Yun Jeong Hong , 25 Hyemin Jang , 26 Hongyoon Choi , 27 Miyoung Choi , 28 Jae-Won Jang 5 , on behalf of Korean Dementia Association
1 Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea 2 Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 3 Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea 4 Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea 5 Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea 6 Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea 7 Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea 8 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea 9 Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea 10Department of Neurology, National Medical Center, Seoul, Korea 11Dr Shin’s Neurology Clinic, Wonju, Korea 12Department of Neurology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 13Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea 14Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea 15Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea 16Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 17Department of Neurology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea 18Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea 19Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea 20Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea 21Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea 22Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 23Department of Neurology, Myungji Hospital, Goyang, Korea 24Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 25Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea 26Department of Neurology, Seoul National University Hospital, Seoul, Korea 27Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea 28Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
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 goldstandard 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.
Key Words: Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Dementia; Meta-Analysis; Alzheimer’s Disease; Frontotemporal Dementia; Lewy Body Disease

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