Affiliations: [a]
Wien Center for Alzheimer’s Disease and Memory Disorder, Mount Sinai Medical Center, Miami Beach, FL, USA | [b]
Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong | [c]
Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, FL, USA | [d]
Departments of Neurology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL and University of Florida College of Medicine, Gainesville, FL, USA | [e]
Department of Neurology, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
Correspondence:
[*]
Correspondence to: Dr. Yat-Fung Shea, Wien Center for Alzheimer’s Disease and Memory Disorder, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA. Tel.: +1 786 328 4069; E-mail: elphashea@gmail.com.
Abstract: Background:Patients with cognitive impairment or dementias of uncertain etiology are frequently referred to a memory disorders specialty clinic. The impact of and role for amyloid PET imaging (Aβ-PET) may be most appropriate in this clinical setting. Objective:The primary objective of this study was to perform a systematic review and meta-analysis of the impact of Aβ-PET on etiological diagnosis and clinical management in the memory clinic setting. Methods:A search of the literature on the impact of Aβ-PET in the memory clinic setting between 1 January 2004 and 12 February 2018 was conducted. Meta-analysis using a random effects model was performed to determine the pooled estimate of the impact of Aβ-PET in the changes of diagnoses and changes in management plan. Results:After rigorous review, results from 13 studies were extracted, involving 1,489 patients. Meta-analysis revealed a pooled effect of change in diagnoses of 35.2% (95% CI 24.6–47.5). Sub-analyses showed that the pooled effect in change in diagnoses if Aβ-PET was used under the appropriate use criteria (AUC) or non-AUC criteria were 47.8% (95% CI 25.9–70.5) and 29.6% (95% CI: 21.5–39.3), respectively. The pooled effect of a change of diagnosis from Alzheimer’s disease (AD) to non-AD and from non-AD to AD were 22.7% (95% CI: 17.1–29.5) and 25.6% (95% CI: 17.6–35.8), respectively. The pooled effect leading to a change of management was 59.6% (95% CI 39.4–77.0). Conclusions:Aβ-PET has a highly significant impact on both changes in diagnosis and management among patients being seen at a specialty memory clinic.
