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Amyloid PET imaging in clinical practice
  1. Magdalena A Kolanko1,2,
  2. Zarni Win3,
  3. Flavia Loreto1,
  4. Neva Patel3,
  5. Christopher Carswell2,4,
  6. Anastassia Gontsarova5,
  7. Richard J Perry1,2,
  8. Paresh A Malhotra1,2,6
  1. 1 Department of Brain Sciences, Imperial College London, London, UK
  2. 2 Department of Clinical Neurosciences, Imperial College Healthcare NHS Trust, London, UK
  3. 3 Department of Nuclear Medicine, Imperial College Healthcare NHS Trust, London, UK
  4. 4 Department of Neurology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  5. 5 Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
  6. 6 UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, UK
  1. Correspondence to Paresh Malhotra, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK; p.malhotra{at}imperial.ac.uk

Abstract

Amyloid positron emission tomography (PET) imaging enables in vivo detection of brain Aβ deposition, one of the neuropathological hallmarks of Alzheimer’s disease. There is increasing evidence to support its clinical utility, with major studies showing that amyloid PET imaging improves diagnostic accuracy, increases diagnostic certainty and results in therapeutic changes. The Amyloid Imaging Taskforce has developed appropriate use criteria to guide clinicians by predefining certain scenarios where amyloid PET would be justified. This review provides a practical guide on how and when to use amyloid PET, based on the available research and our own experience. We discuss its three main appropriate indications and illustrate these with clinical cases. We stress the importance of a multidisciplinary approach when deciding who might benefit from amyloid PET imaging. Finally, we highlight some practical points and common pitfalls in its interpretation.

  • ALZHEIMER’S DISEASE
  • AMYLOID
  • BEHAVIOURAL DISORDER
  • VISUAL ATTENTION
  • ATTENTION
  • COGNITIVE NEUROPSYCHOLOGY
  • COGNITION

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Footnotes

  • Twitter Paresh Malhotra @PareshMalhotra.

  • Contributors MAK wrote the first draft of the manuscript. All authors revised the original draft and contributed to the final submission.

  • Funding The authors receive research funding from the Alzheimer’s Society to examine the clinical use of amyloid PET imaging and are supported by the NIHR Biomedical Research Centre at Imperial College London.

  • Competing interests RP previously sat on an advisory board for Eli Lilly and received support from GE for research imaging from 2014 to 2018. ZW previously also participated in the Eli Lilly PET advisory board and was an amyloid PET read trainer. CC has taken part in an advisory panel for Roche pharmaceuticals. PM has given an educational talk at a meeting organised by GE. None of the authors currently has funding or support from any commercial organisation involved in amyloid PET imaging.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned. Externally peer reviewed by Joshua Klein, Boston, USA.

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