title: Canadian Consensus Guidelines on Use of Amyloid Imaging in Canada: Update and Future Directions from the Specialized Task Force on Amyloid imaging in Canada.
abstract: Positron emission tomography (PET) imaging of brain amyloid beta is now clinically available in several countries including the United States and the United Kingdom, but not Canada. It has become an established technique in the field of neuroimaging of aging and dementia, with data incorporated in the new consensus guidelines for the diagnosis of Alzheimer disease and predementia Alzheimer's disease-related conditions. At this point, there are three US Food and Drug Administration- and European Union-approved tracers. Guided by appropriate use criteria developed in 2013 by the Alzheimer's Association and the Society of Nuclear Medicine and Molecular Imaging, the utility of amyloid imaging in medical practice is now supported by a growing body of research. In this paper, we aimed to provide an update on the 2012 Canadian consensus guidelines to dementia care practitioners on proper use of amyloid imaging. We also wished to generate momentum for the industry to submit a new drug proposal to Health Canada. A group of local, national, and international dementia experts and imaging specialists met to discuss scenarios in which amyloid PET could be used appropriately. Peer-reviewed and published literature between January 2004 and May 2015 was searched. Technical and regulatory considerations pertaining to Canada were considered. The results of a survey of current practices in Canadian dementia centers were considered. A set of specific clinical and research guidelines was agreed on that defines the types of patients and clinical circumstances in which amyloid PET could be used in Canada. Future research directions were also outlined, notably the importance of studies that would assess the pharmaco-economics of amyloid imaging.
authors.affiliation: 1Clinique Interdisciplinaire de Mémoire,CHU de Québec,Quebec City, QC,Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Laforce
authors.affiliation: 3Translational Neuroimaging Laboratory,McGill Center for Studies in Aging,Douglas Mental Health Research Institute,Montreal, QC,Canada.
authors.forename: Pedro
authors.initials: P
authors.lastname: Rosa-Neto
authors.affiliation: 5PET Unit,McConnell Brain Imaging Centre,Montreal Neurological Institute,McGill University,Montreal, QC,Canada.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Soucy
authors.affiliation: 8Memory and Aging Center & Department of Neurology,University of California San Francisco,CA,USA.
authors.forename: Gil D
authors.initials: GD
authors.lastname: Rabinovici
authors.affiliation: 9Centre des Maladies Cognitives et Comportementales,Institut du Cerveau et de la Moelle épinière,Paris,France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubois
authors.affiliation: 4Alzheimer's Disease Research Unit,McGill Center for Studies in Aging,Douglas Mental Health Research Institute,Montreal, QC,Canada.
authors.forename: S
authors.initials: S
authors.lastname: Gauthier
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging*; D000682:Amyloid / Q000378:metabolism*; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D002170:Canada; D032921:Consensus; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D017408:Guidelines as Topic / Q000592:standards*; D006801:Humans; D008279:Magnetic Resonance Imaging; D015337:Multicenter Studies as Topic; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards*
chemical_list: D000682:Amyloid; D016229:Amyloid beta-Peptides; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42)
keywords: Alzheimer’s Disease; Amyloid imaging; Atypical Dementia; Biomarkers; Consensus Guidelines; MCI; PET