Clinical Scenarios for Amyloid and Tau PET
| Clinical scenarios for amyloid PET | Rating* |
|---|---|
| Appropriate | |
| Clinical Scenario 5: Patients presenting with MCI or dementia who are younger than 65 y and in whom AD pathology is suspected | 9 |
| Clinical Scenario 6: Patients presenting with MCI or dementia syndrome that is often consistent with AD pathology (amnestic presentation) with onset at 65 y or older | 8 |
| Clinical Scenario 7: Patients presenting with MCI or dementia syndrome that could be consistent with AD pathology but has atypical features (e.g., nonamnestic clinical presentation, rapid or slow progression, etiologically mixed presentation) | 8 |
| Clinical Scenario 11: Patients with MCI or dementia with equivocal or inconclusive results on recent CSF biomarkers | 8 |
| Clinical Scenario 12: To inform the prognosis of patients presenting with MCI due to clinically suspected AD pathology | 8 |
| Clinical Scenario 14: To determine eligibility for treatment with an approved amyloid-targeting therapy | 9† |
| Clinical Scenario 15: To monitor response among patients who have received an approved amyloid-targeting therapy | 8† |
| Uncertain | |
| Clinical Scenario 4: Patients with SCD (CU based on objective testing) who are considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 6 |
| Clinical Scenario 13: To inform the prognosis of patients presenting with dementia due to clinically suspected AD pathology | 4 |
| Rarely Appropriate | |
| Clinical Scenario 1: Patients who are CU who are not considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 1 |
| Clinical Scenario 2: Patients who are CU but considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 2 |
| Clinical Scenario 3: Patients with SCD (CU based on objective testing) who are not considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 2 |
| Clinical Scenario 8: To determine disease severity or track disease progression in patients with an established biomarker-supported diagnosis of MCI or dementia due to AD pathology | 1 |
| Clinical Scenario 9: Patients presenting with prodromal Lewy body disease or DLB | 2 |
| Clinical Scenario 10: Patients with MCI or dementia with recent CSF biomarker results that are conclusive (whether consistent or not consistent with underlying AD pathology) | 3 |
| Clinical Scenario 16: Nonmedical usage (e.g., legal, insurance coverage, or employment screening) | 1 |
| Clinical Scenario 17: In lieu of genotyping for suspected autosomal dominant mutation carriers | 1 |
| Clinical scenarios for tau PET | Rating* |
|---|---|
| Appropriate | |
| Clinical Scenario 5: Patients presenting with MCI or dementia who are younger than 65 y and in whom AD pathology is suspected | 8 |
| Clinical Scenario 7: Patients presenting with MCI or dementia syndrome that could be consistent with AD pathology but has atypical features (e.g., nonamnestic clinical presentation, rapid or slow progression, etiologically mixed presentation) | 7 |
| Clinical Scenario 12: To inform the prognosis of patients presenting with MCI due to clinically suspected AD pathology | 7 |
| Clinical Scenario 13: To inform the prognosis of patients presenting with dementia due to clinically suspected AD pathology | 7 |
| Clinical Scenario 14: To determine eligibility for treatment with an approved amyloid-targeting therapy | 8† |
| Uncertain | |
| Clinical Scenario 6: Patients presenting with MCI or dementia syndrome that is often consistent with AD pathology (amnestic presentation) with onset at 65 y or older | 6 |
| Clinical Scenario 8: To determine disease severity or track disease progression in patients with an established biomarker-supported diagnosis of MCI or dementia due to AD pathology | 4 |
| Clinical Scenario 9: Patients presenting with prodromal Lewy body disease or DLB | 4 |
| Clinical Scenario 10: Patients with MCI or dementia with recent CSF biomarker results that are conclusive (whether consistent or not consistent with underlying AD pathology) | 6 |
| Clinical Scenario 11: Patients with MCI or dementia with equivocal or inconclusive results on recent CSF biomarkers | 6 |
| Clinical Scenario 15: To monitor response among patients who have received an approved amyloid-targeting therapy | 5 |
| Rarely Appropriate | |
| Clinical Scenario 1: Patients who are CU who are not considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 1 |
| Clinical Scenario 2: Patients who are CU but considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 1 |
| Clinical Scenario 3: Patients with SCD (CU based on objective testing) who are not considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 1 |
| Clinical Scenario 4: Patients with SCD (CU based on objective testing) who are considered to be at increased risk for AD based on age, known APOE4 genotype, or multigenerational family history | 2 |
| Clinical Scenario 16: Nonmedical usage (e.g., legal, insurance coverage, or employment screening) | 1 |
| Clinical Scenario 17: In lieu of genotyping for suspected autosomal dominant mutation carriers | 1 |