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Assessment of the appropriate use criteria for amyloid PET in an unselected memory clinic cohort : The ABIDE project

de Wilde, Arno ; Ossenkoppele, Rik LU ; Pelkmans, Wiesje ; Bouwman, Femke ; Groot, Colin ; van Maurik, Ingrid ; Zwan, Marissa ; Yaqub, Maqsood ; Barkhof, Frederik and Lammertsma, Adriaan A. , et al. (2019) In Alzheimer's and Dementia
Abstract

Introduction: The objective of this study was to assess the usefulness of the appropriate use criteria (AUC) for amyloid imaging in an unselected cohort. Methods: We calculated sensitivity and specificity of appropriate use (increased confidence and management change), as defined by Amyloid Imaging Taskforce in the AUC, and other clinical utility outcomes. Furthermore, we compared differences in post–positron emission tomography diagnosis and management change between “AUC-consistent” and “AUC-inconsistent” patients. Results: Almost half (250/507) of patients were AUC-consistent. In both AUC-consistent and AUC-inconsistent patients, post–positron emission tomography diagnosis (28%–21%) and management (32%–17%) change was substantial.... (More)

Introduction: The objective of this study was to assess the usefulness of the appropriate use criteria (AUC) for amyloid imaging in an unselected cohort. Methods: We calculated sensitivity and specificity of appropriate use (increased confidence and management change), as defined by Amyloid Imaging Taskforce in the AUC, and other clinical utility outcomes. Furthermore, we compared differences in post–positron emission tomography diagnosis and management change between “AUC-consistent” and “AUC-inconsistent” patients. Results: Almost half (250/507) of patients were AUC-consistent. In both AUC-consistent and AUC-inconsistent patients, post–positron emission tomography diagnosis (28%–21%) and management (32%–17%) change was substantial. The Amyloid Imaging Taskforce's definition of appropriate use occurred in 55/507 (13%) patients, detected by the AUC with a sensitivity of 93%, and a specificity of 56%. Diagnostic changes occurred independently of AUC status (sensitivity: 57%, specificity: 53%). Discussion: The current AUC are not sufficiently able to discriminate between patients who will benefit from amyloid positron emission tomography and those who will not.

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publication status
published
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keywords
Alzheimer's disease, Amyloid, Appropriate use criteria, Clinical practice, Dementia, Positron emission tomography
in
Alzheimer's and Dementia
publisher
Elsevier
external identifiers
  • scopus:85072845987
  • pmid:31594684
ISSN
1552-5260
DOI
10.1016/j.jalz.2019.07.003
language
English
LU publication?
yes
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9f1bae52-db96-4bcf-932d-1fb27568e77a
date added to LUP
2019-10-17 10:54:34
date last changed
2020-01-17 03:00:14
@article{9f1bae52-db96-4bcf-932d-1fb27568e77a,
  abstract     = {<p>Introduction: The objective of this study was to assess the usefulness of the appropriate use criteria (AUC) for amyloid imaging in an unselected cohort. Methods: We calculated sensitivity and specificity of appropriate use (increased confidence and management change), as defined by Amyloid Imaging Taskforce in the AUC, and other clinical utility outcomes. Furthermore, we compared differences in post–positron emission tomography diagnosis and management change between “AUC-consistent” and “AUC-inconsistent” patients. Results: Almost half (250/507) of patients were AUC-consistent. In both AUC-consistent and AUC-inconsistent patients, post–positron emission tomography diagnosis (28%–21%) and management (32%–17%) change was substantial. The Amyloid Imaging Taskforce's definition of appropriate use occurred in 55/507 (13%) patients, detected by the AUC with a sensitivity of 93%, and a specificity of 56%. Diagnostic changes occurred independently of AUC status (sensitivity: 57%, specificity: 53%). Discussion: The current AUC are not sufficiently able to discriminate between patients who will benefit from amyloid positron emission tomography and those who will not.</p>},
  author       = {de Wilde, Arno and Ossenkoppele, Rik and Pelkmans, Wiesje and Bouwman, Femke and Groot, Colin and van Maurik, Ingrid and Zwan, Marissa and Yaqub, Maqsood and Barkhof, Frederik and Lammertsma, Adriaan A. and Biessels, Geert Jan and Scheltens, Philip and van Berckel, Bart N. and van der Flier, Wiesje M.},
  issn         = {1552-5260},
  language     = {eng},
  publisher    = {Elsevier},
  series       = {Alzheimer's and Dementia},
  title        = {Assessment of the appropriate use criteria for amyloid PET in an unselected memory clinic cohort : The ABIDE project},
  url          = {http://dx.doi.org/10.1016/j.jalz.2019.07.003},
  doi          = {10.1016/j.jalz.2019.07.003},
  year         = {2019},
}