Why Is Amyloid-β PET Requested After Performing CSF Biomarkers?

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

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.

Detaljer

Författare
  • Juhan Reimand
  • Colin Groot
  • Charlotte E. Teunissen
  • Albert D. Windhorst
  • Ronald Boellaard
  • Frederik Barkhof
  • Sergei Nazarenko
  • Wiesje M. van der Flier
  • Bart N.M. van Berckel
  • Philip Scheltens
  • Rik Ossenkoppele
  • Femke Bouwman
Enheter & grupper
Externa organisationer
  • Tallinn University of Technology
  • VU University Medical Center
  • Vrije Universiteit Amsterdam
  • University College London
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Neurologi

Nyckelord

Originalspråkengelska
Sidor (från-till)559-569
Antal sidor11
TidskriftJournal of Alzheimer's disease : JAD
Volym73
Utgåva nummer2
StatusPublished - 2020 jan 21
PublikationskategoriForskning
Peer review utfördJa