Mathieu Ceccaldi1, Thérèse Jonveaux2, Antoine Verger3, Pierre Krolak-Salmon4, Claire Houzard5, Olivier Godefroy6, Trevor Shields7, Audrey Perrotin8, Rossella Gismondi8, Santiago Bullich9, Aleksandar Jovalekic9, Nicola Raffa10, Florence Pasquier11, Franck Semah12, Bruno Dubois13, Marie-Odile Habert14, David Wallon15, Mathieu Chastan16, Pierre Payoux17, Andrew Stephens9, Eric Guedj18. 1. AP-HM-Hôpital de la Timone, Neurology and Neuropsychology Department, and Aix Marseille University, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France. Electronic address: Mathieu-pierre.CECCALDI@ap-hm.fr. 2. Geriatric Department, CHRU de Nancy-Hôpital Brabois, Vandoeuvre-les-Nancy, France. 3. INSERM U947, Unité d'Imagerie Adaptative Diagnostique et Interventionnelle, Nancy, France. 4. Clinical and Research Memory Center of Lyon, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Inserm 1028, Lyon, France. 5. Nuclear Medicine Department, CHU Lyon, Lyon, France. 6. Neurology Department, CHU Amiens Picardie-Hôpital Sud, Amiens, France. 7. Nuclear Medicine Department, CHU Amiens Picardie-Hôpital Sud, Amiens, France. 8. Piramal Imaging, Medical Affairs, Berlin, Germany. 9. Piramal Imaging, Clinical Research and Development, Berlin, Germany. 10. Piramal Imaging, Market Access and HEOR, Berlin, Germany. 11. Inserm 1171, Université de Lille, CHU, DistAlz, Lille, France. 12. Nuclear Medicine Department, Univ. Lille, U1171, CHU Lille, Lille, France. 13. AP-HP-Hôpital Pitié Salpétrière, Memory and Alzheimer Disease Institute IM2A, Paris, France. 14. Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC Univ Paris 06, Inserm U 1146, CNRS UMR 7371, Paris, France. 15. Neurology Department, CHU de Rouen-Hôpital Charles Nicolle, Rouen, France. 16. Nuclear Medicine Department, Centre Henri Becquerel, Rouen, France. 17. ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France. 18. AP-HM-Hôpital de la Timone, Nuclear Medicine Department, and Aix-Marseille University, CERIMED, CNRS, INT, Institut de Neurosciences de la Timone, Marseille, France.
Abstract
INTRODUCTION: Although some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical implementation in relation to cerebrospinal fluid analysis in a naturalistic setting. METHODS: This multicenter study was performed at French tertiary memory clinics in patients presenting with most complex clinical situations (i.e., early-onset, atypical clinical profiles, suspected mixed etiological conditions, unexpected rate of progression), for whom cerebrospinal fluid analysis was indicated but either not feasible or considered as noncontributory (ClinicalTrials.gov: NCT02681172). RESULTS: Two hundred five patients were enrolled with evaluable florbetaben PET scans; 64.4% of scans were amyloid positive. PET results led to changed diagnosis and improved confidence in 66.8% and 81.5% of patients, respectively, and altered management in 80.0% of cases. DISCUSSION: High-level improvement of diagnostic certainty and management is provided by selective and hierarchical implementation of florbetaben PET into current standard practices for the most complex dementia cases.
INTRODUCTION: Although some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical implementation in relation to cerebrospinal fluid analysis in a naturalistic setting. METHODS: This multicenter study was performed at French tertiary memory clinics in patients presenting with most complex clinical situations (i.e., early-onset, atypical clinical profiles, suspected mixed etiological conditions, unexpected rate of progression), for whom cerebrospinal fluid analysis was indicated but either not feasible or considered as noncontributory (ClinicalTrials.gov: NCT02681172). RESULTS: Two hundred five patients were enrolled with evaluable florbetaben PET scans; 64.4% of scans were amyloid positive. PET results led to changed diagnosis and improved confidence in 66.8% and 81.5% of patients, respectively, and altered management in 80.0% of cases. DISCUSSION: High-level improvement of diagnostic certainty and management is provided by selective and hierarchical implementation of florbetaben PET into current standard practices for the most complex dementia cases.
Authors: Yat-Fung Shea; Warren Barker; Maria T Greig-Gusto; David A Loewenstein; Ranjan Duara; Steven T DeKosky Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
Authors: Yat-Fung Shea; Warren Barker; Maria T Greig-Gusto; David A Loewenstein; Steven T DeKosky; Ranjan Duara Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
Authors: Enrico R Fantoni; Anastasia Chalkidou; John T O' Brien; Gill Farrar; Alexander Hammers Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
Authors: Eva María Triviño-Ibáñez; Raquel Sánchez-Vañó; Pablo Sopena-Novales; Juan Carlos Romero-Fábrega; Antonio Rodríguez-Fernández; Cristóbal Carnero Pardo; María Dolores Martínez Lozano; Manuel Gómez-Río Journal: Medicine (Baltimore) Date: 2019-07 Impact factor: 1.817
Authors: Fermín Segovia; Raquel Sánchez-Vañó; Juan M Górriz; Javier Ramírez; Pablo Sopena-Novales; Nathalie Testart Dardel; Antonio Rodríguez-Fernández; Manuel Gómez-Río Journal: Front Aging Neurosci Date: 2018-06-07 Impact factor: 5.750