Impact of molecular imaging on the diagnostic process in a memory clinic

Rik Ossenkoppele*, Niels D. Prins, Yolande A. L. Pijnenburg, Afina W. Lemstra, Wiesje M. van der Flier, Sofie F. Adriaanse, Albert D. Windhorst, Ron L. H. Handels, Claire A. G. Wolfs, Pauline Aalten, Frans R. J. Verhey, Marcel M. Verbeek, Mark A. van Buchem, Otto S. Hoekstra, Adriaan A. Lammertsma, Philip Scheltens, Bart N. M. van Berckel

*Corresponding author for this work

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Abstract

[C-11]Pittsburgh compound B ([C-11]PIB) and [F-18]-2-fluoro-2-deoxy-D-glucose ([F-18] FDG) PET measure fibrillar amyloid-beta load and glucose metabolism, respectively. We evaluated the impact of these tracers on the diagnostic process in a memory clinic population. Methods: One hundred fifty-four patients underwent paired dynamic [C-11]PIB and static [F-18]FDG PET scans shortly after completing a standard dementia screening. Two-year clinical follow-up data were available for 39 patients. Parametric PET images were assessed visually and results were reported to the neurologists responsible for the initial diagnosis. Outcome measures were (change in) clinical diagnosis and confidence in that diagnosis before and after disclosing PET results. Results: [C-11]PIB scans were positive in 40 of 66 (61%) patients with a clinical diagnosis of Alzheimer's disease (AD), 5 of 18 (28%) patients with frontotemporal dementia (FTD), 4 of 5 (80%) patients with Lewy body dementia, and 3 of I 0 (30%) patients with other dementias. [F-18]FDG uptake patterns matched the clinical diagnosis in 38 of 66 (58%) of AD patients, and in 6 of 18 (33%) FTD patients. PET results led to a change in diagnosis in 35 (23%) patients. This only occurred when prior diagnostic certainty was
Original languageEnglish
Pages (from-to)414-421
JournalAlzheimer's & Dementia
Volume9
Issue number4
DOIs
Publication statusPublished - Jul 2013

Keywords

  • PET
  • [C-11]PIB
  • [F-18]FDG
  • Memory clinic
  • Alzheimer's disease
  • FTD
  • Lewy body dementia
  • MCI
  • SMC

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