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 language | English |
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Article number | 2 |
Number of pages | 8 |
Journal | Alzheimer's Research & Therapy |
Volume | 9 |
Issue number | 1 |
DOIs | |
Publication status | Published - 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