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

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

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)1458-1467
Number of pages10
JournalAlzheimer's & Dementia
Volume15
Issue number11
DOIs
Publication statusPublished - Nov 2019

Keywords

  • Alzheimer's disease
  • Amyloid
  • Appropriate use criteria
  • Clinical practice
  • Dementia
  • Positron emission tomography

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