Brain amyloid PET imaging could assist in diagnosing cognitive impairment in patients who meet certain conditions, according to criteria suggested by the Amyloid Imaging Task Force. The criteria were published in the Journal of Nuclear Medicine and Alzheimer’s & Dementia.
The task force is a joint effort between the Society of Nuclear Medicine and Molecular Imaging and the Alzheimer’s Association.
Beta amyloid plaques can be found among elderly people who are not cognitively impaired, as well as in conditions other than Alzheimer’s disease, so use of amyloid PET should be judicious. PET imaging should only be ordered when appropriately indicated and interpreted by professionals who have been adequately trained, according to the task force report.
Patients with the following conditions would be considered appropriate for beta amyloid PET imaging:
• Patients with persistent or progressive unexplained memory loss or confusion, with impairments found through standard cognition and memory tests
• Patients with an unusual clinical presentation of Alzheimer's disease
• Patients with early onset of progressive dementia (before age 65)
The task force wrote that imaging should not be performed solely based on family history of dementia; the presence of risk factors, such as APOE-e4 gene; for non-medical reasons, such as legal, insurance, or employment requests; or to determine the severity of dementia.
If amyloid PET is selected, the following steps are recommended:
• Evaluation by a dementia expert to assess the need for diagnostic testing, possibly to include amyloid PET if the appropriate use criteria are met.
• Referral to a qualified provider of amyloid PET services.
• Performance, interpretation and reporting of the amyloid PET scan according to established standards.
• Incorporation of the PET result into the clinical assessment process.
• Disclosure of the PET result by the clinician to the patient and caregivers, along with discussion of the result and its management consequences.
The task force acknowledged that more research is required and that both dementia care and amyloid PET technology are in active development. For this reason, there will be more recommendations in the future as the area is more refined.