title: Impact of ¹⁸F-florbetapir PET imaging of β-amyloid neuritic plaque density on clinical decision-making.
abstract: ¹⁸F-florbetapir positron emission tomography (PET) imaging of the brain is now approved by the Food and Drug Administration (FDA) approved for estimation of β -amyloid neuritic plaque density when evaluating patients with cognitive impairment. However, its impact on clinical decision-making is not known. We present 11 cases (age range 67-84) of cognitively impaired subjects in whom clinician surveys were done before and after PET scanning to document the theoretical impact of amyloid imaging on the diagnosis and treatment plan of cognitively impaired subjects. Subjects have been clinically followed for about 5 months after the PET scan. Negative scans occurred in five cases, leading to a change in diagnosis for four patients and a change in treatment plan for two of these cases. Positive scans occurred in six cases, leading to a change in diagnosis for four patients and a change in treatment plan for three of these cases. Following the scan, only one case had indeterminate diagnosis. Our series suggests that both positive and negative florbetapir PET scans may enhance diagnostic certainty and impact clinical decision-making. Controlled longitudinal studies are needed to confirm our data and determine best practices.
authors.affiliation: a Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Zannas
authors.forename: P Murali
authors.initials: PM
authors.lastname: Doraiswamy
authors.forename: Katie S
authors.initials: KS
authors.lastname: Shpanskaya
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Murphy
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Petrella
authors.forename: James R
authors.initials: JR
authors.lastname: Burke
authors.forename: Terence Z
authors.initials: TZ
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000188:drug therapy; D016229:Amyloid beta-Peptides / Q000378:metabolism*; D000814:Aniline Compounds; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D060825:Cognitive Dysfunction / Q000209:etiology / Q000523:psychology; D003937:Diagnosis, Differential; D005026:Ethylene Glycols; D005260:Female; D057180:Frontotemporal Dementia / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology; D009483:Neuropsychological Tests; D058225:Plaque, Amyloid / Q000000981:diagnostic imaging* / Q000523:psychology / Q000628:therapy; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D016229:Amyloid beta-Peptides; D000814:Aniline Compounds; D002800:Cholinesterase Inhibitors; D005026:Ethylene Glycols; D019275:Radiopharmaceuticals; C545186:florbetapir