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Alzheimers Dement. 2018 Mar;14(3):293-305. doi: 10.1016/j.jalz.2017.09.009. Epub 2017 Nov 4.

Added value of 18F-florbetaben amyloid PET in the diagnostic workup of most complex patients with dementia in France: A naturalistic study.

Author information

1
AP-HM-Hôpital de la Timone, Neurology and Neuropsychology Department, and Aix Marseille University, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France. Electronic address: Mathieu-pierre.CECCALDI@ap-hm.fr.
2
Geriatric Department, CHRU de Nancy-Hôpital Brabois, Vandoeuvre-les-Nancy, France.
3
INSERM U947, Unité d'Imagerie Adaptative Diagnostique et Interventionnelle, Nancy, France.
4
Clinical and Research Memory Center of Lyon, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Inserm 1028, Lyon, France.
5
Nuclear Medicine Department, CHU Lyon, Lyon, France.
6
Neurology Department, CHU Amiens Picardie-Hôpital Sud, Amiens, France.
7
Nuclear Medicine Department, CHU Amiens Picardie-Hôpital Sud, Amiens, France.
8
Piramal Imaging, Medical Affairs, Berlin, Germany.
9
Piramal Imaging, Clinical Research and Development, Berlin, Germany.
10
Piramal Imaging, Market Access and HEOR, Berlin, Germany.
11
Inserm 1171, Université de Lille, CHU, DistAlz, Lille, France.
12
Nuclear Medicine Department, Univ. Lille, U1171, CHU Lille, Lille, France.
13
AP-HP-Hôpital Pitié Salpétrière, Memory and Alzheimer Disease Institute IM2A, Paris, France.
14
Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC Univ Paris 06, Inserm U 1146, CNRS UMR 7371, Paris, France.
15
Neurology Department, CHU de Rouen-Hôpital Charles Nicolle, Rouen, France.
16
Nuclear Medicine Department, Centre Henri Becquerel, Rouen, France.
17
ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.
18
AP-HM-Hôpital de la Timone, Nuclear Medicine Department, and Aix-Marseille University, CERIMED, CNRS, INT, Institut de Neurosciences de la Timone, Marseille, France.

Abstract

INTRODUCTION:

Although some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical implementation in relation to cerebrospinal fluid analysis in a naturalistic setting.

METHODS:

This multicenter study was performed at French tertiary memory clinics in patients presenting with most complex clinical situations (i.e., early-onset, atypical clinical profiles, suspected mixed etiological conditions, unexpected rate of progression), for whom cerebrospinal fluid analysis was indicated but either not feasible or considered as noncontributory (ClinicalTrials.gov: NCT02681172).

RESULTS:

Two hundred five patients were enrolled with evaluable florbetaben PET scans; 64.4% of scans were amyloid positive. PET results led to changed diagnosis and improved confidence in 66.8% and 81.5% of patients, respectively, and altered management in 80.0% of cases.

DISCUSSION:

High-level improvement of diagnostic certainty and management is provided by selective and hierarchical implementation of florbetaben PET into current standard practices for the most complex dementia cases.

KEYWORDS:

Alzheimer's disease; Amyloid imaging; Clinical practice; Diagnosis; Florbetaben; Patient management

PMID:
29107051
DOI:
10.1016/j.jalz.2017.09.009
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