Cited by 194Dementia and Cognitive Impairment ResearchMedical Imaging Techniques and ApplicationsAlzheimer's disease research and treatments

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Impact of molecular imaging on the diagnostic process in a memory clinic

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Ossenkoppele, Rik, Prins, Niels D., Pijnenburg, Yolande A.L., Lemstra, Afina W., van der Flier, Wiesje M., Adriaanse, Sofie F., Windhorst, Albert D., Handels, Ron L.H., Wolfs, Claire A.G., Aalten, Pauline, Verhey, Frans R.J., Verbeek, Marcel M., van Buchem, Mark A., Hoekstra, Otto S., Lammertsma, Adriaan A., Scheltens, Philip, van Berckel, Bart N.M.·2013·Alzheimer's & Dementia

DOI 10.1016/j.jalz.2012.07.003

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Abstract

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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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)
Maastricht University Medical Centre (NL)
Radboud University Medical Center (NL)
Leiden University Medical Center (NL)
Corresponding author: Ossenkoppele, Rik
ORCID: Ossenkoppele, Rik
Prins, Niels D.
Pijnenburg, Yolande A.L.
Lemstra, Afina W.
van der Flier, Wiesje M.
Windhorst, Albert D.
Handels, Ron L.H.
Wolfs, Claire A.G.
Verhey, Frans R.J.
Verbeek, Marcel M.
van Buchem, Mark A.
Hoekstra, Otto S.
Lammertsma, Adriaan A.
Scheltens, Philip
van Berckel, Bart N.M.
Venue: Alzheimer's & Dementia
Publisher: Wiley
Published: 2012-11-19
Volume: 9
Issue: 4
Pages: 414-421
ISSN: 1552-5260 (ISSN-L)
1552-5279
DOI: 10.1016/j.jalz.2012.07.003
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
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
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
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › 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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