Why Is Amyloid-β PET Requested After Performing CSF Biomarkers?
(2020) In Journal of Alzheimer's disease : JAD 73(2). p.559-569- Abstract
BACKGROUND: Amyloid-β positron emission tomography (PET) and cerebrospinal fluid (CSF) Aβ42 are considered interchangeable for clinical diagnosis of Alzheimer's disease. OBJECTIVE: To explore the clinical reasoning for requesting additional amyloid-β PET after performing CSF biomarkers. METHODS: We retrospectively identified 72 memory clinic patients who underwent amyloid-β PET after CSF biomarkers analysis for clinical diagnostic evaluation between 2011 and 2019. We performed patient chart reviews to identify factors which led to additional amyloid-β PET. Additionally, we assessed accordance with appropriate-use-criteria (AUC) for amyloid-β PET. RESULTS: Mean patient age was 62.0 (SD = 8.1) and mean Mini-Mental State Exam score was... (More)
BACKGROUND: Amyloid-β positron emission tomography (PET) and cerebrospinal fluid (CSF) Aβ42 are considered interchangeable for clinical diagnosis of Alzheimer's disease. OBJECTIVE: To explore the clinical reasoning for requesting additional amyloid-β PET after performing CSF biomarkers. METHODS: We retrospectively identified 72 memory clinic patients who underwent amyloid-β PET after CSF biomarkers analysis for clinical diagnostic evaluation between 2011 and 2019. We performed patient chart reviews to identify factors which led to additional amyloid-β PET. Additionally, we assessed accordance with appropriate-use-criteria (AUC) for amyloid-β PET. RESULTS: Mean patient age was 62.0 (SD = 8.1) and mean Mini-Mental State Exam score was 23.6 (SD = 3.8). CSF analysis conflicting with the clinical diagnosis was the most frequent reason for requesting an amyloid-β PET scan (n = 53, 74%), followed by incongruent MRI (n = 16, 22%), unusual clinical presentation (n = 11, 15%) and young age (n = 8, 11%). An amyloid-β PET scan was rarely (n = 5, 7%) requested in patients with a CSF Aβ+/tau+ status. Fifteen (47%) patients with a post-PET diagnosis of AD had a predominantly non-amnestic presentation. In n = 11 (15%) cases, the reason that the clinician requested amyloid-β was not covered by AUC. This happened most often (n = 7) when previous CSF analysis did not support current clinical diagnosis, which led to requesting amyloid-β PET. CONCLUSION: In this single-center study, the main reason for requesting an amyloid-β PET scan after performing CSF biomarkers was the occurrence of a mismatch between the primary clinical diagnosis and CSF Aβ/tau results.
(Less)
- author
- organization
- publishing date
- 2020-01-21
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Alzheimer’s disease, amyloid, cerebrospinal fluid, positron emission tomography, tau proteins
- in
- Journal of Alzheimer's disease : JAD
- volume
- 73
- issue
- 2
- pages
- 11 pages
- publisher
- IOS Press
- external identifiers
-
- scopus:85078507057
- pmid:31796674
- ISSN
- 1387-2877
- DOI
- 10.3233/JAD-190836
- language
- English
- LU publication?
- yes
- id
- 7831eec0-78aa-4978-bdf8-93da45bb42df
- date added to LUP
- 2020-02-06 15:03:44
- date last changed
- 2024-05-29 08:01:22
@article{7831eec0-78aa-4978-bdf8-93da45bb42df,
abstract = {{<p>BACKGROUND: Amyloid-β positron emission tomography (PET) and cerebrospinal fluid (CSF) Aβ42 are considered interchangeable for clinical diagnosis of Alzheimer's disease. OBJECTIVE: To explore the clinical reasoning for requesting additional amyloid-β PET after performing CSF biomarkers. METHODS: We retrospectively identified 72 memory clinic patients who underwent amyloid-β PET after CSF biomarkers analysis for clinical diagnostic evaluation between 2011 and 2019. We performed patient chart reviews to identify factors which led to additional amyloid-β PET. Additionally, we assessed accordance with appropriate-use-criteria (AUC) for amyloid-β PET. RESULTS: Mean patient age was 62.0 (SD = 8.1) and mean Mini-Mental State Exam score was 23.6 (SD = 3.8). CSF analysis conflicting with the clinical diagnosis was the most frequent reason for requesting an amyloid-β PET scan (n = 53, 74%), followed by incongruent MRI (n = 16, 22%), unusual clinical presentation (n = 11, 15%) and young age (n = 8, 11%). An amyloid-β PET scan was rarely (n = 5, 7%) requested in patients with a CSF Aβ+/tau+ status. Fifteen (47%) patients with a post-PET diagnosis of AD had a predominantly non-amnestic presentation. In n = 11 (15%) cases, the reason that the clinician requested amyloid-β was not covered by AUC. This happened most often (n = 7) when previous CSF analysis did not support current clinical diagnosis, which led to requesting amyloid-β PET. CONCLUSION: In this single-center study, the main reason for requesting an amyloid-β PET scan after performing CSF biomarkers was the occurrence of a mismatch between the primary clinical diagnosis and CSF Aβ/tau results.</p>}},
author = {{Reimand, Juhan and Groot, Colin and Teunissen, Charlotte E. and Windhorst, Albert D. and Boellaard, Ronald and Barkhof, Frederik and Nazarenko, Sergei and van der Flier, Wiesje M. and van Berckel, Bart N.M. and Scheltens, Philip and Ossenkoppele, Rik and Bouwman, Femke}},
issn = {{1387-2877}},
keywords = {{Alzheimer’s disease; amyloid; cerebrospinal fluid; positron emission tomography; tau proteins}},
language = {{eng}},
month = {{01}},
number = {{2}},
pages = {{559--569}},
publisher = {{IOS Press}},
series = {{Journal of Alzheimer's disease : JAD}},
title = {{Why Is Amyloid-β PET Requested After Performing CSF Biomarkers?}},
url = {{http://dx.doi.org/10.3233/JAD-190836}},
doi = {{10.3233/JAD-190836}},
volume = {{73}},
year = {{2020}},
}