Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units

The clinical utility of amyloid positron emission tomography (PET) has not been fully established. Our aim was to evaluate the effect of amyloid imaging on clinical decision making in a secondary care unit and compare our results with a previous study in a tertiary center following the same methods....

Full description

Bibliographic Details
Authors: Lage Martínez, Carmen, González Suarez, Andrea, Pozueta, Ana, Riancho Zarrabeitia, Javier, Kazimierczak, Martha Eryka, Bravo, María, Jiménez Bonilla, Julio Francisco|||0000-0001-5494-6609, Arcocha Torres, María de, Quirce Pisano, María Remedios, Banzo, Ignacio, Vázquez Higuera, José Luis, Rabinovici, Gil D., Rodríguez Rodríguez, Eloy Manuel, Pascual Sánchez, Juan
Format: article
Publication Date:2018
Country:España
Institution:Universidad de Cantabria (UC)
Repository:UCrea Repositorio Abierto de la Universidad de Cantabria
Language:English
OAI Identifier:oai:repositorio.unican.es:10902/22824
Online Access:http://hdl.handle.net/10902/22824
Access Level:Open access
Keyword:Alzheimer’s disease
FDG
PET
PIB
Amyloid
Dementia
id ES_a8f93d56a356799746bb3f0331868ee7
oai_identifier_str oai:repositorio.unican.es:10902/22824
network_acronym_str ES
network_name_str España
repository_id_str
spelling Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory UnitsLage Martínez, CarmenGonzález Suarez, AndreaPozueta, AnaRiancho Zarrabeitia, JavierKazimierczak, Martha ErykaBravo, MaríaJiménez Bonilla, Julio Francisco|||0000-0001-5494-6609Arcocha Torres, María deQuirce Pisano, María RemediosBanzo, IgnacioVázquez Higuera, José LuisRabinovici, Gil D.Rodríguez Rodríguez, Eloy ManuelPascual Sánchez, JuanAlzheimer’s diseaseFDGPETPIBAmyloidDementiaThe clinical utility of amyloid positron emission tomography (PET) has not been fully established. Our aim was to evaluate the effect of amyloid imaging on clinical decision making in a secondary care unit and compare our results with a previous study in a tertiary center following the same methods. We reviewed retrospectively 151 cognitively impaired patients who underwent amyloid (Pittsburgh compound B [PiB]) PET and were evaluated clinically before and after the scan in a secondary care unit. One hundred and fifty concurrently underwent fluorodeoxyglucose (FDG)-PET. We assessed changes between the pre- and post-PET clinical diagnosis and Alzheimer's disease treatment plan. The association between PiB/FDG results and changes in management was evaluated using ?2 and multivariate logistic regression. Concordance between classification based on scan readings and baseline diagnosis was 66% for PiB and 47% for FDG. The primary diagnosis changed after PET in 17.2% of cases. When examined independently, discordant PiB and discordant FDG were both associated with diagnostic change (p < 0.0001). However, when examined together in a multivariate logistic regression, only discordant PiB remained significant (p = 0.0002). Changes in treatment were associated with concordant PiB (p = 0.009) while FDG had no effect on treatment decisions. Based on our regression model, patients with diagnostic dilemmas, a suspected non-amyloid syndrome, and Clinical Dementia Rating <1 were more likely to benefit from amyloid PET due to a higher likelihood of diagnostic change. We found that changes in diagnosis after PET in our secondary center almost doubled those of our previous analysis of a tertiary unit (9% versus 17.2%). Our results offer some clues about the rational use of amyloid PET in a secondary care memory unit stressing its utility in mild cognitive impairment patients.IOS PressUniversidad de Cantabria20182018-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttp://hdl.handle.net/10902/22824J Alzheimers Dis. 2018;63(3):1025-1033reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/228242026-06-02T12:39:31Z
dc.title.none.fl_str_mv Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
title Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
spellingShingle Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
Lage Martínez, Carmen
Alzheimer’s disease
FDG
PET
PIB
Amyloid
Dementia
title_short Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
title_full Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
title_fullStr Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
title_full_unstemmed Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
title_sort Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units
dc.creator.none.fl_str_mv Lage Martínez, Carmen
González Suarez, Andrea
Pozueta, Ana
Riancho Zarrabeitia, Javier
Kazimierczak, Martha Eryka
Bravo, María
Jiménez Bonilla, Julio Francisco|||0000-0001-5494-6609
Arcocha Torres, María de
Quirce Pisano, María Remedios
Banzo, Ignacio
Vázquez Higuera, José Luis
Rabinovici, Gil D.
Rodríguez Rodríguez, Eloy Manuel
Pascual Sánchez, Juan
author Lage Martínez, Carmen
author_facet Lage Martínez, Carmen
González Suarez, Andrea
Pozueta, Ana
Riancho Zarrabeitia, Javier
Kazimierczak, Martha Eryka
Bravo, María
Jiménez Bonilla, Julio Francisco|||0000-0001-5494-6609
Arcocha Torres, María de
Quirce Pisano, María Remedios
Banzo, Ignacio
Vázquez Higuera, José Luis
Rabinovici, Gil D.
Rodríguez Rodríguez, Eloy Manuel
Pascual Sánchez, Juan
author_role author
author2 González Suarez, Andrea
Pozueta, Ana
Riancho Zarrabeitia, Javier
Kazimierczak, Martha Eryka
Bravo, María
Jiménez Bonilla, Julio Francisco|||0000-0001-5494-6609
Arcocha Torres, María de
Quirce Pisano, María Remedios
Banzo, Ignacio
Vázquez Higuera, José Luis
Rabinovici, Gil D.
Rodríguez Rodríguez, Eloy Manuel
Pascual Sánchez, Juan
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Alzheimer’s disease
FDG
PET
PIB
Amyloid
Dementia
topic Alzheimer’s disease
FDG
PET
PIB
Amyloid
Dementia
description The clinical utility of amyloid positron emission tomography (PET) has not been fully established. Our aim was to evaluate the effect of amyloid imaging on clinical decision making in a secondary care unit and compare our results with a previous study in a tertiary center following the same methods. We reviewed retrospectively 151 cognitively impaired patients who underwent amyloid (Pittsburgh compound B [PiB]) PET and were evaluated clinically before and after the scan in a secondary care unit. One hundred and fifty concurrently underwent fluorodeoxyglucose (FDG)-PET. We assessed changes between the pre- and post-PET clinical diagnosis and Alzheimer's disease treatment plan. The association between PiB/FDG results and changes in management was evaluated using ?2 and multivariate logistic regression. Concordance between classification based on scan readings and baseline diagnosis was 66% for PiB and 47% for FDG. The primary diagnosis changed after PET in 17.2% of cases. When examined independently, discordant PiB and discordant FDG were both associated with diagnostic change (p < 0.0001). However, when examined together in a multivariate logistic regression, only discordant PiB remained significant (p = 0.0002). Changes in treatment were associated with concordant PiB (p = 0.009) while FDG had no effect on treatment decisions. Based on our regression model, patients with diagnostic dilemmas, a suspected non-amyloid syndrome, and Clinical Dementia Rating <1 were more likely to benefit from amyloid PET due to a higher likelihood of diagnostic change. We found that changes in diagnosis after PET in our secondary center almost doubled those of our previous analysis of a tertiary unit (9% versus 17.2%). Our results offer some clues about the rational use of amyloid PET in a secondary care memory unit stressing its utility in mild cognitive impairment patients.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10902/22824
url http://hdl.handle.net/10902/22824
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv IOS Press
publisher.none.fl_str_mv IOS Press
dc.source.none.fl_str_mv J Alzheimers Dis. 2018;63(3):1025-1033
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869415962216759296
score 15.301603

Similar Items