Impact of molecular imaging on the diagnostic process in a memory clinic
Open accessAbstract
Background: [ 11 C]Pittsburgh compound B ([ 11 C]PIB) and [ 18 F]‐2‐fluoro‐2‐deoxy‐D‐glucose ([ 18 F]FDG) PET measure fibrillar amyloid‐β 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 [ 11 C]PIB and static [ 18 F]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: [ 11 C]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 10 (30%) patients with other dementias. [ 18 F]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 <90%. Diagnostic confidence increased from 71 ± 17% before to 87 ± 16% after PET ( p < .001). Two‐year clinical follow‐up ( n = 39) showed that [ 11 C]PIB and [ 18 F]FDG predicted progression to AD for patients with mild cognitive impairment, and that the diagnosis of dementia established after PET remained unchanged in 96% of patients. Conclusions: In a memory clinic setting, combined [ 11 C]PIB and [ 18 F]FDG PET are of additional value on top of the standard diagnostic work‐up, especially when prior diagnostic confidence is low.
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A similar proportion of individuals clinically diagnosed as AD dementia have normal amyloid PET or CSF Aβ42 studies.
“and a similar proportion has normal amyloid PET or CSF Aβ42 studies [53–62].”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [59]
Amyloid PET is part of biomarker screening in AD diagnostic criteria.
“It is part of the biomarker screening in the AD diagnostic criteria and can help particularly in the diagnosis of young onset AD and differentiate from other dementias such as bvFTD [156, 157].”
From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [157]
Amyloid PET can help particularly in diagnosis of young onset AD and differentiate from other dementias such as bvFTD.
“It is part of the biomarker screening in the AD diagnostic criteria and can help particularly in the diagnosis of young onset AD and differentiate from other dementias such as bvFTD [156, 157].”
From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [157]
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Self-citationTowards clinical application of tau PET tracers for diagnosing dementia due to Alzheimer's disease
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Self-citationDifferentiating the Frontal Presentation of Alzheimer's Disease with FDG-PET
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Patient and caregiver reactions to clinical amyloid imaging
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Self-citationImaging the Role of Amyloid in PD Dementia and Dementia with Lewy Bodies
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Self-citationNeuroimaging of Alzheimer’s disease: focus on amyloid and tau PET
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Amyloid‐ β PET and CSF in an autopsy‐confirmed cohort
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Self-citationPET Agents in Dementia: An Overview
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Amyloid and Tau PET Imaging of Alzheimer Disease and Other Neurodegenerative Conditions
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[11C]PIB amyloid quantification: effect of reference region selection
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Self-citationImpact of Amyloid PET Imaging in the Memory Clinic: A Systematic Review and Meta-Analysis
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Latent atrophy factors related to phenotypical variants of posterior cortical atrophy
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Outcomes of clinical utility in amyloid-PET studies: state of art and future perspectives
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Self-citationClinical impact of 18F-FDG-PET among memory clinic patients with uncertain diagnosis
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Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer’s disease
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Dual-phase [18F]florbetapir in frontotemporal dementia
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Prognostic plasma protein panel for Aβ deposition in the brain in Alzheimer’s disease
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Amyloid imaging in clinical trials
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Self-citationImaging amyloidopathy in Parkinson disease and parkinsonian dementia syndromes
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Molecular Imaging of Alzheimer Disease Pathology
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Amyloid Imaging With 11C-PIB in Patients With Cognitive Impairment in a Clinical Setting
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- Authors
- Ossenkoppele, R., Prins, N. D., Pijnenburg, Y. A. L., Lemstra, A. W., van der Flier, W. M., Adriaanse, S. F., Windhorst, A. D., Handels, R. L. H., Wolfs, C. A. G., Aalten, P., Verhey, F. R. J., Verbeek, M. M., van Buchem, M. A., Hoekstra, O. S., Lammertsma, A. A., Scheltens, P., & van Berckel, B. N. M.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Department of Neurology and Alzheimer Center VU University Medical Center Amsterdam The Netherlands
- Maastricht University Medical Centre (NL)
- Radboud University Medical Center (NL)
- Department of Laboratory Medicine Radboud University Nijmegen Medical Centre Nijmegen The Netherlands
- Department of Nuclear Medicine and PET Research VU University Medical Center Amsterdam The Netherlands
- Corresponding author
- Ossenkoppele, Rik
- ORCID
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2012-11-19
- Volume
- 9
- Issue
- 4
- Pages
- 414-421
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- OpenAlex
- W2137348301
- Cited by
- 194
- References
- 37
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 8 · 2023: 10 · 2022: 7 · 2021: 19 · 2020: 16 · 2019: 21 · 2018: 20 · 2017: 18 · 2016: 16 · 2015: 26 · 2014: 12 · 2013: 10
- FWCI
- 10.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Center for Translational Molecular Medicine (02N-101)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- amyloid PET, Pittsburgh compound B
- MeSH terms
- Aged, Alzheimer Disease, Aniline Compounds, Brain, Carbon Radioisotopes, Dementia, Diagnosis, Differential, Female, Fluorine Radioisotopes, Follow-Up Studies, France, Humans, Male, Memory Disorders, Middle Aged, Outpatient Clinics, Hospital, Prospective Studies, Sensitivity and Specificity, Thiazoles, Treatment Outcome, Disease Progression, Radiopharmaceuticals, Fluorodeoxyglucose F18, Lewy Body Disease, Early Diagnosis, Positron-Emission Tomography, Molecular Imaging, Frontotemporal Dementia
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