Impact of amyloid-PET in daily clinical management of patients with cognitive impairment fulfilling appropriate use criteria
Por:
Triviño-Ibáñez EM, Sánchez-Vañó R, Sopena-Novales P, Romero-Fábrega JC, Rodríguez-Fernández A, Carnero Pardo C, Martínez Lozano MD and Gómez-Río M
Publicada:
1 jul 2019
Categoría:
Medicine (miscellaneous)
Resumen:
To evaluate the use of amyloid-positron emission tomography (PET) in routine clinical practice, in a selected population with cognitive impairment that meets appropriate use criteria (AUC).
A multicenter, observational, prospective case-series study of 211 patients from 2 level-3 hospitals who fulfilled clinical AUC for amyloid-PET scan in a naturalistic setting. Certainty degree was evaluated using a 5-point Likert scale: 0 (very low probability); 1 (low probability); 2 (intermediate probability); 3 (high probability); and 4 (practically sure), before and after amyloid PET. The treatment plan was considered as cognition-specific or noncognition-specific.
Amyloid-PET was positive in 118 patients (55.9%) and negative in 93 patients (44.1%). Diagnostic prescan confidence according amyloid-PET results showed that in both, negative and positive-PET subgroup, the most frequent category was intermediate probability (45.7% and 55.1%, respectively). After the amyloid-PET, the diagnostic confidence showed a very different distribution, that was, in the negative-PET group the most frequent categories are very unlikely (70.7%) and unlikely (29.3%), while in the positive-PET group were very probable (57.6%) and practically sure (39%). Only in 14/211 patients (6.6%) the result of the amyloid-PET did not influence the diagnostic confidence, while in 194 patients (93.4%), the diagnostic confidence improved significantly after amyloid-PET results. The therapeutic intention was modified in 93 patients (44.1%). Specific treatment for Alzheimer disease was started, before amyloid-PET, in 80 patients (37.9%).
This naturalistic study provides evidence that the implementation of amyloid-PET is associated with a significant improvement in diagnostic confidence and has a high impact on the therapeutic management of patients with mild cognitive impairment fulfilled clinical AUC.
Filiaciones:
Triviño-Ibáñez EM:
Department of Nuclear Medicine, Virgen de las Nieves University Hospital
IBS, Granada Bio-Health Research Institute, Granada
Sánchez-Vañó R:
Department of Nuclear Medicine, La Fe University Hospital, Clinical Medicine and Public Health Doctoral Program of the University of Granada
Sopena-Novales P:
Department of Nuclear Medicine, Hospital 9 de Octubre, Valencia
Romero-Fábrega JC:
Department of Neurology, Virgen de las Nieves University Hospital
Rodríguez-Fernández A:
Department of Nuclear Medicine, Virgen de las Nieves University Hospital
IBS, Granada Bio-Health Research Institute, Granada
Carnero Pardo C:
IBS, Granada Bio-Health Research Institute, Granada
Fidyan Neurocenter, Granada
:
Neurology Department Memory and Dementia Unit, Hospital La Magdalena, Castellón, Spain
Gómez-Río M:
Department of Nuclear Medicine, Virgen de las Nieves University Hospital
IBS, Granada Bio-Health Research Institute, Granada
gold, Green Published
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