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PET scans could improve dementia diagnosis in two-thirds of patients

by Thomas Dworetzky, Contributing Reporter | July 19, 2017
Alzheimers/Neurology Molecular Imaging PET
Amyloid-β PET scans have great clinical value in diagnosing dementia patients, according to new studies reported at the Alzheimer's Association International Conference (AAIC) 2017 in London.

The findings revealed that the scans altered the diagnosis in two thirds of the patients, which flies in the face of “the prevailing wisdom, [which] has been that PET imaging does not provide sufficient additional diagnostic accuracy to justify its cost,” according to an association statement.

The studies determined that brain PET imaging “allows for more accurate detection or exclusion of Alzheimer's in a larger proportion of individuals than standard clinical assessment supported by structural and metabolic imaging, and cerebrospinal fluid.”
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"A negative brain PET scan indicating sparse to no amyloid plaques rules out Alzheimer's disease as the cause of dementia symptoms,” said Dr. James A. Hendrix, Alzheimer's Association director of Global Science Initiatives.

At the meeting it was reported that an analysis of Medicare claims data found that approximately 60 percent of dementia cases were missed in clinical practice, particularly cases of early dementia.

"A swift and accurate diagnosis has a huge impact on access to Alzheimer's treatments, eligibility for research trials, plus much-needed support and information services," added Hendrix.

In one study at Oslo University Hospital, Dr. Nenad Bogdanovic, found that amyloid PET imaging was “a key contributor to either diagnosing or excluding a diagnosis of Alzheimer's disease in all 50 (100 percent) of participants.”

This compared to CSF amyloid testing, which permitted clinicians to make a diagnosis or exclusion in 88 percent of patients with a higher detection cutoff, and in only 42 percent using traditional cutoffs.

Another small study of a 135 people by doctoral student Antoine Leuzy, MSc, of Karolinska Institute in Stockholm, showed that 68 percent of 61 individuals with mild cognitive impairment had a change in diagnosis after PET scanning.

Another study by Dr. Enrico Fantoni of GE Healthcare in Amersham, U.K., looked at data from previous clinical trials, from 2000 to 2017, of brain amyloid PET scans. It found that the PET scans led to a diagnosis change in 20 percent of the individuals.

This makes the PET scanning “a valuable tool to clarify an uncertain or difficult diagnosis," advised Hendrix, adding, that misdiagnosis is “costly” to health systems, and “expensive and distressing” to those suffering with dementia as well as their families.

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