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Use of amyloid PET across the spectrum of Alzheimer's disease: clinical utility and associated ethical issues
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Section of Nuclear Medicine and PET.
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2014 (English)In: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 21, no 3, 143-148 p.Article, review/survey (Refereed) Published
Abstract [en]

Recent advances have made possible the in vivo detection of beta-amyloid (Ab) pathology using positron emission tomography. While the gold standard for amyloid imaging, carbon-11 labeled Pittsburgh compound B is increasingly being replaced by fluorine-18 labeled radiopharmaceuticals, with three already approved for clinical use by US and European regulatory bodies. Appropriate use criteria proposed by an amyloid imaging taskforce convened by the Alzheimer's Association and the Society of Nuclear Medicine and Molecular Imaging recommend restricting use of this technology to the evaluation of patients with mild cognitive impairment or atypical dementia syndromes. While use among asymptomatic individuals is currently viewed as inappropriate due prognostic uncertainty, elevated levels of brain Ab among asymptomatic individuals may represent preclinical Alzheimer's disease. Amyloid imaging is likewise expected to play a role in the design of clinical trials. Though preliminary results suggest amyloid imaging to possess clinical utility and cost-effectiveness, both domains have yet to be assessed systematically. As the field moves toward adoption of a pro-disclosure stance for amyloid imaging findings, it is imperative that a broad range of stakeholders be involved to ensure the appropriateness of emerging policies and protocols.

Place, publisher, year, edition, pages
2014. Vol. 21, no 3, 143-148 p.
Keyword [en]
[F-18]Florbetapir, [F-18]flutemetamol, appropriate use criteria, diagnosis, mild cognitive impairment, positron emission tomography
National Category
Radiology, Nuclear Medicine and Medical Imaging Clinical Medicine
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URN: urn:nbn:se:uu:diva-232200DOI: 10.3109/13506129.2014.926267ISI: 000340428000001OAI: oai:DiVA.org:uu-232200DiVA: diva2:748922
Available from: 2014-09-22 Created: 2014-09-15 Last updated: 2017-12-05Bibliographically approved

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Heurling, Kerstin

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