First guidelines for brain amyloid imaging may aid Alzheimer's diagnosis
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the Alzheimer's Association have jointly published the first criteria for the appropriate use of positron emission tomography (PET) to aid in the diagnosis of people with suspected Alzheimer's disease.
Only recently has it become possible to create high-quality images of the brain plaques characteristic of Alzheimer's disease in living people through PET. But questions remain about what can be learned from these PET images and which people should have this test.
The guidelines for brain amyloid imaging were released to provide guidance for physicians, individuals and families affected by Alzheimer's, and the public.
"Our primary goal is to provide healthcare practitioners with the information and options available to provide patients with the best possible diagnosis and care in a cost effective manner," said Maria Carrillo, Ph.D., Alzheimer's Association vice president of Medical and Scientific Relations.
While elevated beta amyloid plaques are one of the defining pathologic features of Alzheimer's, many elderly people with normal cognition also have elevated levels of these plaques, as do people with conditions other than Alzheimer's dementia. Therefore, the potential clinical use of amyloid PET requires careful consideration so that its proper role may be identified.
To develop the new criteria, the Alzheimer's Association and SNMMI assembled an Amyloid Imaging Taskforce (AIT) consisting of dementia and imaging experts to review the scientific literature and develop consensus recommendations for the clinical use of this promising new technology.
The AIT concluded that amyloid imaging could potentially be helpful in the diagnosis of people with cognitive impairment when considered along with other clinical information, and when performed according to standardized protocols by trained staff.
In addition, they emphasized that the decision whether or not to order amyloid imaging should be made only after a comprehensive evaluation by a physician experienced in the assessment and diagnosis of cognitive impairment and dementia, and only if the presence or absence of amyloid would increase certainty in the diagnosis and alter the treatment plan.
"As amyloid imaging becomes more prevalent in clinical settings, medical professionals must understand how to appropriately utilize the test," said Frederic H. Fahey, D.Sc., SNMMI president.
The criteria were published online as an article "in press" by Alzheimer's and Dementia: The Journal of the Alzheimer's Association and "ahead of print" in The Journal of Nuclear Medicine.