Clinical assessment of amyloid imaging in Alzheimer's disease: a systematic review of the literature.
OBJECTIVE
Healthcare systems face an increased prevalence of Alzheimer's disease and increasing costs. The use of molecular biomarkers and imaging could offer an effective solution for these issues. The objective of this study was to assess amyloid imaging regarding clinical utility and impact.


METHODS
A literature search was performed in several databases, searching articles between 2008 and January 2013 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The results are reported according to the clinical correlates of amyloid imaging.


RESULTS
Thirty-three studies were included in the final analysis. Five studies evaluated amyloid imaging for diagnosis. Nine studies assessed the prognostic value. Twenty-two studies provided correlations to cognitive measures. Amyloid imaging provides a high reliability in diagnosis and prognosis, but cognitive measures only showed weak correlations.


CONCLUSIONS
The evidence clearly indicated that amyloid imaging has not arrived yet in clinical practice. However, it can provide substantial benefits in special aspects of diagnostic accuracy and for a diagnosis up to 10 years before clinical diagnosis. This can be a base for early preventive treatment strategies such as anti-amyloid therapy. In this context, amyloid imaging is crucial to understand the early pathologic process in Alzheimer's disease.
Interdisciplinary Center for Health Technology Assessment and Public Health, University of Erlangen-Nuremberg, National Cluster of Excellence 'Medical Technologies - Medical Valley EMN', Erlangen, Germany.
Philip
P
Wahlster
Charlotte
C
Niederländer
Christine
C
Kriza
Sandra
S
Schaller
Peter L
PL
Kolominsky-Rabas
D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D000682:Amyloid / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D000682:Amyloid; D015415:Biomarkers