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Neurocase

Behavior, Cognition and Neuroscience
Volume 20, 2014 - Issue 4
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Original Articles

Impact of 18F-florbetapir PET imaging of β-amyloid neuritic plaque density on clinical decision-making

, , , , , & show all
Pages 466-473
Received 27 Nov 2012
Accepted 28 Mar 2013
Published online: 14 May 2013

18F-florbetapir positron emission tomography (PET) imaging of the brain is now approved by the Food and Drug Administration (FDA) approved for estimation of β-amyloid neuritic plaque density when evaluating patients with cognitive impairment. However, its impact on clinical decision-making is not known. We present 11 cases (age range 67–84) of cognitively impaired subjects in whom clinician surveys were done before and after PET scanning to document the theoretical impact of amyloid imaging on the diagnosis and treatment plan of cognitively impaired subjects. Subjects have been clinically followed for about 5 months after the PET scan. Negative scans occurred in five cases, leading to a change in diagnosis for four patients and a change in treatment plan for two of these cases. Positive scans occurred in six cases, leading to a change in diagnosis for four patients and a change in treatment plan for three of these cases. Following the scan, only one case had indeterminate diagnosis. Our series suggests that both positive and negative florbetapir PET scans may enhance diagnostic certainty and impact clinical decision-making. Controlled longitudinal studies are needed to confirm our data and determine best practices.

Grant Support: supported by a grant from Avid.

Disclosures: Subjects in this study were enrolled and scanned as part of a multicenter study funded by Avid. PMD and TZW have received advisory fees and research grants from Avid as well as several other companies. PMD owns shares in Sonexa, Clarimedix and Adverse Events whose products are not discussed here. JRP received advisory fees from Janssen.

 

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