Abstract
The diagnosis of dementia probably due to Alzheimer's disease is still primarily a clinical one. In cases that remain clinically unclear, however, biomarkers for amyloid deposition and neuronal injury can help to identify the underlying cause. One biomarker even for early neuronal injury in the stage of mild cognitive impairment is cerebral glucose hypometabolism measured by 18F-FDG PET. Distinct patterns of hypometabolism can be seen, for example, in dementia due to Alzheimer's disease, frontotemporal lobar degeneration, and dementia with Lewy bodies. This makes it possible to distinguish between different neurodegenerative diseases as well as major depressive disorder. While the sensitivity of 18F-FDG PET to detect Alzheimer's disease is high, specificity is low and the additional use of biomarkers for amyloid deposition might be beneficial in some cases. In conclusion, 18F-FDG PET is a useful tool when the cause for dementia remains unclear and different diagnosis would lead to different treatment approaches. Due to the lack of treatment options in pre-dementia stages, the use of 18F-FDG PET is currently not recommended for these cases in a purely clinical setting.
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