Article Text

other Versions

PDF
Research paper
Clinical utility of amyloid PET imaging with (18)F-florbetapir: a retrospective study of 100 patients
  1. Christopher James Carswell1,
  2. Zarni Win2,
  3. Kirsty Muckle1,
  4. Angus Kennedy1,
  5. Adam Waldman3,
  6. Gemma Dawe2,
  7. Tara D Barwick4,5,
  8. Sameer Khan4,
  9. Paresh A Malhotra1,6,
  10. Richard J Perry1,6
  1. 1Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
  2. 2Department of Neuroradiology, Imperial College Healthcare NHS Trust, London, UK
  3. 3Centre for Clinical Brain Sciences, Brain Research Imaging Centre, University of Edinburgh, Edinburgh, UK
  4. 4Department of Nuclear Medicine, Imperial College Healthcare NHS Trust, London, UK
  5. 5Division of Cancer and Surgery, Imperial College, London, UK
  6. 6Division of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
  1. Correspondence to Dr Richard J Perry, Department of Neurology, Imperial NHS Trust, Charing Cross Hospital, London W6 8RF, UK; richard.perry{at}imperial.nhs.uk

Abstract

Background and objective Amyloid-positron emission tomography (PET) imaging (API) detects amyloid-beta pathology early in the course of Alzheimer’s disease (AD) with high sensitivity and specificity. (18)F-florbetapir (Amyvid) is an amyloid-binding PET ligand with a half-life suitable for clinical use outside of the research setting. How API affects patient investigation and management in the ‘real-world’ arena is unknown. To address this, we retrospectively documented the effect of API in patients in the memory clinic.

Methods We reviewed the presenting clinical features, the pre-API and post-API investigations, diagnosis and outcomes for the first 100 patients who had API as part of their routine work-up at the Imperial Memory Centre, a tertiary referral clinic in the UK National Health Service.

Results API was primarily used to investigate patients with atypical clinical features (56 cases) or those that were young at onset (42 cases). MRI features of AD did not always predict positive API (67%), and 6 of 23 patients with MRIs reported as normal were amyloid-PET positive. There were significantly more cases categorised as non-AD dementia post-API (from 11 to 23). Patients investigated when API was initially available had fewer overall investigations and all patients had significantly fewer investigations in total post-API.

Conclusions API has a clear impact on the investigation of young-onset or complex dementia while reducing the overall burden of investigations. It was most useful in younger patients, atypical presentations or individuals with multiple possible causes of cognitive impairment.

  • image analysis
  • pet
  • pet, functional imaging

Statistics from Altmetric.com

Footnotes

  • Contributors The study was designed by RP, PAM and AW, the data were acquired and presented by CJC, KM, RK, TB, AK, AW, ZW, the data was interpreted by CJC, PM and RP, figures were created by CJC, the paper was written and revised by CJC, KM, RK, AK, PAM, GD, TB, ZW and RP.

  • Funding The patients were investigated within their treatment in the NHS. No specific external funding was acquired. This work was supported by the NIHR Biomedical Research Centre at Imperial College London.

  • Competing interests RP has worked in an advisory role for Roche, Eli Lilly, Merck, and GE. PM has a ‘drugs-only’ grant from Shire Pharmaceuticals and research funding from the UK National Institute of Health Research and Medical Research Council.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement We will consider sharing our data on request.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.