TY - JOUR
T1 - Amyloid-PET and 18F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias
AU - Chételat, Gaël
AU - Arbizu, Javier
AU - Barthel, Henryk
AU - Garibotto, Valentina
AU - Law, Ian
AU - Morbelli, Silvia
AU - van de Giessen, Elsmarieke
AU - Agosta, Federica
AU - Barkhof, Frederik
AU - Brooks, David J.
AU - Carrillo, Maria C.
AU - Dubois, Bruno
AU - Fjell, Anders M.
AU - Frisoni, Giovanni B.
AU - Hansson, Oskar
AU - Herholz, Karl
AU - Hutton, Brian F.
AU - Jack, Clifford R.
AU - Lammertsma, Adriaan A.
AU - Landau, Susan M.
AU - Minoshima, Satoshi
AU - Nobili, Flavio
AU - Nordberg, Agneta
AU - Ossenkoppele, Rik
AU - Oyen, Wim J.G.
AU - Perani, Daniela
AU - Rabinovici, Gil D.
AU - Scheltens, Philip
AU - Villemagne, Victor L.
AU - Zetterberg, Henrik
AU - Drzezga, Alexander
N1 - Funding Information:
We thank John Bean (Bean Medical Writing, Halle, Belgium; funded by EANM) for providing medical writing services, which included taking the minutes of the EANM Focus 2 meeting, amending text of the Personal View to include EANM Focus Meeting 2 content; editing drafts to improve the accuracy of language, flow, organisation, structure, and overall readability; and checking for grammatical and spelling errors. The authors also thank Susanne Koebe and other EANM staff members for project management. This research was funded by the European Association of Nuclear Medicine and supported by unrestricted grants from Siemens Healthineers, Biogen, Cerveau Technologies, Life Molecular Imaging, and Lilly. These sponsors had no direct or indirect influence on the programme and content of the EANM Focus 2 meeting and the writing or content of this Personal View. FB and BH are supported by the NIHR University College London Hospitals Biomedical Research Centre. The AMYPAD project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement number 115952). The IDEAS study was funded by the Alzheimer's Association, the American College of Radiology, Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), General Electric Healthcare, and Life Molecular Imaging (formerly Piramal Imaging). The US Centers for Medicare and Medicaid Services provided coverage for amyloid-PET scans in DEAS under coverage with evidence development.
Funding Information:
We thank John Bean (Bean Medical Writing, Halle, Belgium; funded by EANM) for providing medical writing services, which included taking the minutes of the EANM Focus 2 meeting, amending text of the Personal View to include EANM Focus Meeting 2 content; editing drafts to improve the accuracy of language, flow, organisation, structure, and overall readability; and checking for grammatical and spelling errors. The authors also thank Susanne Koebe and other EANM staff members for project management. This research was funded by the European Association of Nuclear Medicine and supported by unrestricted grants from Siemens Healthineers, Biogen, Cerveau Technologies, Life Molecular Imaging, and Lilly. These sponsors had no direct or indirect influence on the programme and content of the EANM Focus 2 meeting and the writing or content of this Personal View. FB and BH are supported by the NIHR University College London Hospitals Biomedical Research Centre. The AMYPAD project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement number 115952). The IDEAS study was funded by the Alzheimer's Association, the American College of Radiology, Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), General Electric Healthcare, and Life Molecular Imaging (formerly Piramal Imaging). The US Centers for Medicare and Medicaid Services provided coverage for amyloid-PET scans in DEAS under coverage with evidence development.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/11
Y1 - 2020/11
N2 - Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and 18F-fluorodeoxyglucose (18F-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information. However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise. We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia. We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and 18F-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation. We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies.
AB - Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and 18F-fluorodeoxyglucose (18F-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information. However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise. We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia. We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and 18F-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation. We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies.
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U2 - 10.1016/S1474-4422(20)30314-8
DO - 10.1016/S1474-4422(20)30314-8
M3 - Review article
C2 - 33098804
AN - SCOPUS:85092900781
SN - 1474-4422
VL - 19
SP - 951
EP - 962
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 11
ER -