Diagnostic impact of [18F]flutemetamol PET in early-onset dementia

Marissa D. Zwan*, Femke H. Bouwman, Elles Konijnenberg, Wiesje M. van der Flier, Adriaan A. Lammertsma, Frans R. J. Verhey, Pauline Aalten, Bart N. M. van Berckel, Philip Scheltens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Early-onset dementia patients often present with atypical clinical symptoms, hampering an accurate clinical diagnosis. The purpose of the present study was to assess the diagnostic impact of the amyloid-positron emission tomography (PET) imaging agent [F-18] flutemetamol in early-onset dementia patients, in terms of change in (confidence in) diagnosis and patient management plan.

Methods: This prospective bi-center study included 211 patients suspected of early-onset dementia who visited a tertiary memory clinic. Patients were eligible with Mini Mental State Examination >= 18 and age at diagnosis

Results: [F-18] flutemetamol PET scans were positive in 133 out of 211 (63%) patients, of whom 110 out of 144 (76%) patients had a pre-PET Alzheimer's disease (AD) diagnosis and 23 out of 67 (34%) patients had a non-AD diagnosis. After disclosure of PET results, 41/211 (19%) diagnoses changed. Overall, diagnostic confidence increased from 69 +/- 12% to 88 +/- 15% after disclosing PET results (P <0.001; in 87% of patients). In 79 (37%) patients, PET results led to a change in patient management and predominantly the initiation of AD medication when PET showed evidence for amyloid pathology.

Conclusions: [F-18] flutemetamol PET changed clinical diagnosis, increased overall diagnostic confidence, and altered the patient management plan. Our results suggest that amyloid PET may have added value over the standardized diagnostic work-up in early-onset dementia patients with uncertain clinical diagnosis. This study provides evidence for the recommendations put forward in the appropriate use criteria for amyloid PET in clinical practice.

Original languageEnglish
Article number2
Number of pages8
JournalAlzheimer's Research & Therapy
Volume9
DOIs
Publication statusPublished - 17 Jan 2017

Keywords

  • Alzheimer's disease
  • Dementia
  • Clinical practice
  • Diagnostic impact
  • Positron emission tomography
  • Imaging
  • Amyloid
  • PROGRESSIVE SUPRANUCLEAR PALSY
  • ALZHEIMERS-DISEASE
  • FRONTOTEMPORAL DEMENTIA
  • INTERNATIONAL WORKSHOP
  • NATIONAL INSTITUTE
  • DECISION-MAKING
  • CASE SERIES
  • BETA
  • CRITERIA
  • MANAGEMENT

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