This review article aims at providing a state-of-the-art review of the role of fluorodeoxyglucose
(FDG) positron emission tomography (PET) imaging (FDG-PET) in the prediction of Alzheimer's
dementia in subjects suffering mild cognitive impairment (MCI), with a particular focus on
the predictive power of FDG-PET compared to structural magnetic resonance imaging (sMRI). We
also address perfusion single photon emission computed tomography (SPECT) as a less costly and
more accessible alternative to FDG-PET.
A search in PubMed was performed, taking into consideration relevant scientific articles published in
English within the last five years and limited to human studies. This recent literature confirms the effectiveness
of FDG-PET and sMRI for prediction of AD dementia in MCI. However, there are discordant
results regarding which image modality is superior. This could be explained by the high variability
of metrics used to evaluate both imaging modalities and/or by sampling/population issues such
as age, disease severity and conversion time. FDG-PET seems to outperform sMRI in rapidly converting
early-onset MCI individuals, whereas sMRI may outperform FDG-PET in late-onset MCI
subjects, in which case FDG PET might only provide a complementary role. Although FDG-PET performs
better than perfusion SPECT, current evidence confirms perfusion SPECT as a valid alternative
when FDG- PET is not available. Finally, possible future directions in the field are discussed.