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Critical review of the Appropriate Use Criteria for amyloid imaging: Effect on diagnosis and patient care.

  • Author(s): Apostolova, Liana G
  • Haider, Janelle M
  • Goukasian, Naira
  • Rabinovici, Gil D
  • Chételat, Gael
  • Ringman, John M
  • Kremen, Sarah
  • Grill, Joshua D
  • Restrepo, Lucas
  • Mendez, Mario F
  • Silverman, Daniel H
  • et al.
Abstract

INTRODUCTION:The utility of the Appropriate Use Criteria (AUC) for amyloid imaging is not established. METHODS:Fifty-three cognitively impaired patients with clinical F18-florbetapir imaging were classified as early and late onset, as well as AUC-consistent or AUC-inconsistent. Chi-square statistics and t test were used to compare demographic characteristics and clinical outcomes as appropriate. RESULTS:Early-onset patients were more likely to be amyloid positive. Change in diagnosis was more frequent in late-onset cases. Change in therapy was more common in early-onset cases. AUC-consistent and AUC-inconsistent cases had comparable rates of amyloid positivity. We saw no difference in the rate of treatment changes in the AUC-consistent group as opposed to the AUC-inconsistent group. DISCUSSION:The primary role of amyloid imaging in the early-onset group was to confirm the clinically suspected etiology, and in the late-onset group in detecting amyloid-negative cases. The rate of therapeutic changes was significantly greater in the early-onset cases.

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