Effect of Amyloid Imaging on the Diagnosis and Management of Patients with Cognitive Decline: Impact of Appropriate Use Criteria

Dement Geriatr Cogn Disord. 2016;41(1-2):80-92. doi: 10.1159/000441139. Epub 2016 Jan 8.

Abstract

Background: Published appropriate use criteria (AUC) describe patients for whom amyloid positron emission tomography (PET) might be most useful. This study compared the impact of amyloid PET on diagnosis and management in subjects likely to either meet or not meet AUC.

Methods: Physicians provided a provisional diagnosis and management plan for patients presenting with cognitive decline before and after amyloid PET imaging with florbetapir F 18. Participants were classified as AUC-like or not, based on the prescan diagnosis and demographic features.

Results: In all, 125 of 229 participants (55%) were classified as AUC-like. Sixty-two percent of the AUC-like subjects had a change in diagnosis after scanning compared with 45% of the non-AUC subjects (p = 0.011). Both groups demonstrated high rates of change in their management plans after scanning (88.0% for AUC-like cases, 85.6% for non-AUC cases).

Conclusions: The impact of amyloid imaging on diagnosis and planned management was maintained and, if anything, amplified in AUC-like patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / drug therapy
  • Amyloid / analysis*
  • Amyloid beta-Peptides / analysis
  • Aniline Compounds
  • Brain / diagnostic imaging
  • Cognition
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / drug therapy
  • Ethylene Glycols
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Positron-Emission Tomography
  • Radiopharmaceuticals

Substances

  • Amyloid
  • Amyloid beta-Peptides
  • Aniline Compounds
  • Ethylene Glycols
  • Radiopharmaceuticals
  • florbetapir