Clinical impact of amyloid PET using 18F-florbetapir in patients with cognitive impairment and suspected Alzheimer’s disease: a multicenter study
| العنوان: | Clinical impact of amyloid PET using 18F-florbetapir in patients with cognitive impairment and suspected Alzheimer’s disease: a multicenter study |
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| المؤلفون: | Hiroshi Matsuda, Kyoji Okita, Yumiko Motoi, Toshiki Mizuno, Manabu Ikeda, Nobuo Sanjo, Koji Murakami, Taiki Kambe, Toshiki Takayama, Kei Yamada, Takashi Suehiro, Keiko Matsunaga, Takanori Yokota, Ukihide Tateishi, Yoko Shigemoto, Yukio Kimura, Emiko Chiba, Takahiro Kawashima, Yui Tomo, Hisateru Tachimori, Yuichi Kimura, Noriko Sato |
| المصدر: | Annals of Nuclear Medicine. 36:1039-1049 |
| بيانات النشر: | Springer Science and Business Media LLC, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Radiology, Nuclear Medicine and imaging, General Medicine |
| الوصف: | Objective Amyloid positron emission tomography (PET) can reliably detect senile plaques and fluorinated ligands are approved for clinical use. However, the clinical impact of amyloid PET imaging is still under investigation. The aim of this study was to evaluate the diagnostic impact and clinical utility in patient management of amyloid PET using 18F-florbetapir in patients with cognitive impairment and suspected Alzheimer’s disease (AD). We also aimed to determine the cutoffs for amyloid positivity for quantitative measures by investigating the agreement between quantitative and visual assessments. Methods Ninety-nine patients suspected of having AD underwent 18F-florbetapir PET at five institutions. Site-specialized physicians provided a diagnosis of AD or non-AD with a percentage estimate of their confidence and their plan for patient management in terms of medication, prescription dosage, additional diagnostic tests, and care planning both before and after receiving the amyloid imaging results. A PET image for each patient was visually assessed and dichotomously rated as either amyloid-positive or amyloid-negative by four board-certified nuclear medicine physicians. The PET images were also quantitatively analyzed using the standardized uptake value ratio (SUVR) and Centiloid (CL) scale. Results Visual interpretation obtained 48 positive and 51 negative PET scans. The amyloid PET results changed the AD and non-AD diagnosis in 39 of 99 patients (39.3%). The change rates of 26 of the 54 patients (48.1%) with a pre-scan AD diagnosis were significantly higher than those of 13 of the 45 patients with a pre-scan non-AD diagnosis (χ2 = 5.334, p = 0.0209). Amyloid PET results also resulted in at least one change to the patient management plan in 42 patients (42%), mainly medication (20 patients, 20%) and care planning (25 patients, 25%). Receiver-operating characteristic analysis determined the best agreement of the quantitative assessments and visual interpretation of PET scans to have an area under the curve of 0.993 at an SUVR of 1.19 and CL of 25.9. Conclusion Amyloid PET using 18F-florbetapir PET had a substantial clinical impact on AD and non-AD diagnosis and on patient management by enhancing diagnostic confidence. In addition, the quantitative measures may improve the visual interpretation of amyloid positivity. |
| تدمد: | 1864-6433 0914-7187 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::864756471a0622906f3b9f63380e83ce https://doi.org/10.1007/s12149-022-01792-y |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........864756471a0622906f3b9f63380e83ce |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 18646433 09147187 |
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