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- W4256028434 abstract "We evaluated the impact of amyloid and FDG PET on clinical decision making in a heterogeneous population of cognitively impaired patients. We selected all patients with FDG and PIB PET and had at least one clinical evaluation before and after PET. We evaluated for change in primary diagnosis and change in treatment between the pre- and post-PET visit. The association of discordant PIB and FDG with changes in clinical management was assessed separately using chi-square and together applying logistic regression. 140 cognitively impaired patients were included in thestudy (mean age 65.0 ± 8.2, 46.% primary Aβ diagnosis, 55.0% of new patients, mean MMSE 22.7 ± 9.0, 41.0 % CDR<1). PIB and FDG PET agreed in classifying 83.6% of patients. Concordance with pre-scan diagnosis was 84.3% for PIB and 82.1% for FDG. The primary diagnosis was changed after PET in 13/140 patients (9.3%): 12/13 changes were concordant with PIB and 8/13 with FDG results. When examined independently, both discordant PIB and discordant FDG were associated with a change in diagnosis (p<0.0001). However, multivariate analysis revealed that changes in diagnosis were associated with discordant PIB (p=0.00013) but not discordant FDG (p=0.087) (LRadditional covariates: clinical dilemmas pre -PET, gender, age at PET, baseline diagnosis, new patient (follow up before PET of less than 1 year) and CDR <1) 35% of patients had a change in AD therapy post-PET (initiating or discontinuing acetycholinesterase inhibitors or memantine). In the entire population changes in treatment were not associated with discordant PIB or discordant FDG (p>0.05 in LR model); however discordant PIB did affect treatment in of patients with non-Aβ pre-PET diagnoses (p=0.028), driven by the initiation of acetycholinesterase inhibitors in patients who were unexpectedly PIB-positive. Overall concordance of PET amyloid and FDG results with clinical diagnosis was high and changes in diagnosis were uncommon. Discordant PIB had a greater effect on diagnostic changes than discordant FDG. Impact on treatment was more modest than on diagnosis and limited to Aβ negative patients." @default.
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- W4256028434 date "2013-07-01" @default.
- W4256028434 modified "2023-09-27" @default.
- W4256028434 title "P1-305: The practical utility of amyloid and FDG-PET in an academic dementia center" @default.
- W4256028434 doi "https://doi.org/10.1016/j.jalz.2013.05.531" @default.
- W4256028434 hasPublicationYear "2013" @default.
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