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Why Is Amyloid-β PET Requested After Performing CSF Biomarkers?
- Source :
- Journal of Alzheimer's Disease, 73(2), 559-569. IOS Press, Journal of Alzheimer's Disease, Reimand, J, Groot, C, Teunissen, C E, Windhorst, A D, Boellaard, R, Barkhof, F, Nazarenko, S, van der Flier, W M, van Berckel, B N M, Scheltens, P, Ossenkoppele, R & Bouwman, F 2020, ' Why Is Amyloid-β PET Requested After Performing CSF Biomarkers? ', Journal of Alzheimer's Disease, vol. 73, no. 2, pp. 559-569 . https://doi.org/10.3233/JAD-190836
- Publication Year :
- 2020
- Publisher :
- IOS Press, 2020.
-
Abstract
- BACKGROUND: Amyloid-β positron emission tomography (PET) and cerebrospinal fluid (CSF) Aβ42 are considered interchangeable for clinical diagnosis of Alzheimer's disease. OBJECTIVE: To explore the clinical reasoning for requesting additional amyloid-β PET after performing CSF biomarkers. METHODS: We retrospectively identified 72 memory clinic patients who underwent amyloid-β PET after CSF biomarkers analysis for clinical diagnostic evaluation between 2011 and 2019. We performed patient chart reviews to identify factors which led to additional amyloid-β PET. Additionally, we assessed accordance with appropriate-use-criteria (AUC) for amyloid-β PET. RESULTS: Mean patient age was 62.0 (SD = 8.1) and mean Mini-Mental State Exam score was 23.6 (SD = 3.8). CSF analysis conflicting with the clinical diagnosis was the most frequent reason for requesting an amyloid-β PET scan (n = 53, 74%), followed by incongruent MRI (n = 16, 22%), unusual clinical presentation (n = 11, 15%) and young age (n = 8, 11%). An amyloid-β PET scan was rarely (n = 5, 7%) requested in patients with a CSF Aβ+/tau+ status. Fifteen (47%) patients with a post-PET diagnosis of AD had a predominantly non-amnestic presentation. In n = 11 (15%) cases, the reason that the clinician requested amyloid-β was not covered by AUC. This happened most often (n = 7) when previous CSF analysis did not support current clinical diagnosis, which led to requesting amyloid-β PET. CONCLUSION: In this single-center study, the main reason for requesting an amyloid-β PET scan after performing CSF biomarkers was the occurrence of a mismatch between the primary clinical diagnosis and CSF Aβ/tau results.
- Subjects :
- Male
0301 basic medicine
medicine.medical_specialty
positron emission tomography
Neurology
Amyloid β
tau Proteins
Neuropsychological Tests
cerebrospinal fluid
03 medical and health sciences
0302 clinical medicine
Cerebrospinal fluid
Alzheimer Disease
Physicians
medicine
Humans
In patient
Aged
Retrospective Studies
Amyloid beta-Peptides
medicine.diagnostic_test
business.industry
General Neuroscience
Memory clinic
amyloid
General Medicine
Middle Aged
Mental Status and Dementia Tests
Magnetic Resonance Imaging
Peptide Fragments
Psychiatry and Mental health
Clinical Psychology
030104 developmental biology
Positron emission tomography
Positron-Emission Tomography
Clinical diagnosis
Csf biomarkers
Female
Radiology
Geriatrics and Gerontology
business
Alzheimer’s disease
Biomarkers
030217 neurology & neurosurgery
Research Article
Subjects
Details
- ISSN :
- 18758908 and 13872877
- Volume :
- 73
- Database :
- OpenAIRE
- Journal :
- Journal of Alzheimer's Disease
- Accession number :
- edsair.doi.dedup.....0c018a4f2b76d2dc66fce05568c7f7aa