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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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“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]
In the citing paper
“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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“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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Metadata
- 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
- 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
- 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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