Abstract
Currently, three amyloid PET tracers are approved and commercially available for clinical use. They allow for the accurate in vivo detection of amyloid plaques, one hallmark of Alzheimer’s disease (AD). Here, we review the current knowledge on the clinical use and utility of amyloid imaging. Appropriate use criteria for the clinical application of amyloid imaging are established, and most currently available data point to their validity. Visual amyloid image analysis is highly standardized. Disclosure of amyloid imaging results is desired by many cognitively impaired subjects, and seems to be safe once appropriate education is delivered to the disclosing clinicians. Regarding clinical utility, increasing evidence points i) to a change of diagnosis via amyloid imaging in ~30% of cases, ii) to an increase of diagnostic confidence in ~60% of cases, iii) to a change of patient management in ~60% of cases, and specifically iv) to a change of medication in ~40% of cases. Also, amyloid imaging results seem to relevantly impact care-givers. Further, initial simulation studies point to a potential positive patient outcome effect and cost-effectiveness of amyloid imaging. These features, however, will require confirmation in prospective clinical trials. More work is also required to determine the clinical utility of amyloid imaging specifically in subjects with mild cognitive impairment, and in comparison/conjunction with other AD biomarkers. Taken together, the clinical use of amyloid imaging is being studied, and the currently available data point to a relevant clinical utility of this imaging technique. Ongoing research will determine whether this accurate and non-invasive approach to amyloid plaque load detection will translate into a benefit to cognitively impaired subjects.
- Copyright © 2017 by the Society of Nuclear Medicine and Molecular Imaging, Inc.