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Assessment of the appropriate use criteria for amyloid PET in an unselected memory clinic cohort: The ABIDE project

2019; Wiley; Volume: 15; Issue: 11 Linguagem: Inglês

10.1016/j.jalz.2019.07.003

1552-5279

Arno de Wilde, Rik Ossenkoppele, Wiesje Pelkmans, Femke H. Bouwman, Colin Groot, Ingrid S. van Maurik, Marissa D. Zwan, Maqsood Yaqub, Frederik Barkhof, Adriaan A. Lammertsma, Geert Jan Biessels, Philip Scheltens, Bart N.M. van Berckel, Wiesje M. van der Flier,

Amyloidosis: Diagnosis, Treatment, Outcomes

Abstract Introduction The objective of this study was to assess the usefulness of the appropriate use criteria (AUC) for amyloid imaging in an unselected cohort. Methods We calculated sensitivity and specificity of appropriate use (increased confidence and management change), as defined by Amyloid Imaging Taskforce in the AUC, and other clinical utility outcomes. Furthermore, we compared differences in post–positron emission tomography diagnosis and management change between “AUC‐consistent” and “AUC‐inconsistent” patients. Results Almost half (250/507) of patients were AUC‐consistent. In both AUC‐consistent and AUC‐inconsistent patients, post–positron emission tomography diagnosis (28%–21%) and management (32%–17%) change was substantial. The Amyloid Imaging Taskforce's definition of appropriate use occurred in 55/507 (13%) patients, detected by the AUC with a sensitivity of 93%, and a specificity of 56%. Diagnostic changes occurred independently of AUC status (sensitivity: 57%, specificity: 53%). Discussion The current AUC are not sufficiently able to discriminate between patients who will benefit from amyloid positron emission tomography and those who will not.