title: Clinical use of amyloid-positron emission tomography neuroimaging: Practical and bioethical considerations.
abstract: Until recently, estimation of β-amyloid plaque density as a key element for identifying Alzheimer's disease (AD) pathology as the cause of cognitive impairment was only possible at autopsy. Now with amyloid-positron emission tomography (amyloid-PET) neuroimaging, this AD hallmark can be detected antemortem. Practitioners and patients need to better understand potential diagnostic benefits and limitations of amyloid-PET and the complex practical, ethical, and social implications surrounding this new technology. To complement the practical considerations, Eli Lilly and Company sponsored a Bioethics Advisory Board to discuss ethical issues that might arise from clinical use of amyloid-PET neuroimaging with patients being evaluated for causes of cognitive decline. To best address the multifaceted issues associated with amyloid-PET neuroimaging, we recommend this technology be used only by experienced imaging and treating physicians in appropriately selected patients and only in the context of a comprehensive clinical evaluation with adequate explanations before and after the scan.
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Witte
authors.affiliation: Center for Alzheimer's Care, Imaging and Research, Department of Neurology, The Brain Institute, University of Utah, Salt Lake City, UT, USA.
authors.forename: Norman L
authors.initials: NL
authors.lastname: Foster
authors.affiliation: Banner Alzheimer's Institute, Phoenix, AZ, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Fleisher
authors.affiliation: IPC The Hospitalist Company, Inc., St. Louis, MO, USA; VITAS Innovative Hospice, St. Louis, MO, USA.
authors.forename: Monique M
authors.initials: MM
authors.lastname: Williams
authors.affiliation: Indiana University Center for Bioethics, Indianapolis, IN, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Quaid
authors.affiliation: Division of Geriatric Medicine, University of Colorado Denver School of Medicine, Aurora, CO, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Wasserman
authors.affiliation: National Alliance for Caregiving, Bethesda, MD, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Hunt
authors.affiliation: Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
authors.forename: J Scott
authors.initials: JS
authors.lastname: Roberts
authors.affiliation: Memory & Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Gil D
authors.initials: GD
authors.lastname: Rabinovici
authors.affiliation: Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Levenson
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Hake
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Hunter
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Luann E
authors.initials: LE
authors.lastname: Van Campen
authors.affiliation: Avid Radiopharmaceuticals, Philadelphia, PA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pontecorvo
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Hochstetler
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Linda B
authors.initials: LB
authors.lastname: Tabas
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Paula T
authors.initials: PT
authors.lastname: Trzepacz
keywords: Alzheimer's disease; Amyloid-β; Bioethics in neurology; Biomarkers; Dementia; Diagnostic use; Mild cognitive impairment; Positron emission tomography