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Title of Journal: Eur Arch Psychiatry Clin Neurosci

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Abbravation: European Archives of Psychiatry and Clinical Neuroscience

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Springer Berlin Heidelberg

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DOI

10.1006/pest.1993.1029

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1433-8491

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Systematic review of the diagnostic utility of SPE

Authors: Jing Ming Yeo Xuxin Lim Zubair Khan Suvankar Pal
Publish Date: 2013/08/06
Volume: 263, Issue: 7, Pages: 539-552
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Abstract

Singlephoton emissioncomputed tomography SPECT may potentially contribute to the diagnostic work up of patients with neurodegenerative dementia This systematic review aims to establish the diagnostic utility of 99mTchexamethylpropyleneamine 99mTcHMPAO and 99mTcethylcysteine dimer SPECT in distinguishing between Alzheimer’s disease AD and frontotemporal dementia FTD AD and vascular dementia VD AD and dementia with Lewy bodies DLB and AD and normal controls NC We searched MEDLINE and Embase databases via OVID for articles from January 1985 to May 2012 and identified additional studies from reviews and references Of 755 studies 49 studies met the inclusion and exclusion criteria for this systematic review AD versus FTD n = 13 AD versus VD n = 18 AD versus DLB n = 5 and AD versus NC n = 18 We compiled relevant data and graded the studies with an internal and external validity criteria checklist We pooled the studies with a clinical diagnosis and those using 99mTcHMPAO SPECT in a metaanalysis calculating the pooled weighted sensitivity specificity likelihood ratios and diagnostic odds ratios using DerSimonian–Laird randomeffects model The pooled weighted sensitivity and specificity of 99mTcHMPAOSPECT in distinguishing clinically diagnosed AD from FTD are 797 and 799  respectively AD from VD are 745 and 724  AD from DLB are 702 and 762  and AD from NC are 761 and 854  SPECT does have diagnostic value particularly in differentiating Alzheimer’s disease from frontotemporal dementia and normal controls however it should not be used in isolation rather as an adjunct and interpreted in the context of clinical information and paraclinical test results

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