Amyloid Imaging

While elevated beta amyloid plaques are one of the defining pathologic features of Alzheimer’s, many elderly people with normal cognition also have elevated levels of these plaques, as do people with conditions other than Alzheimer’s dementia. Therefore, the potential clinical use of amyloid PET requires careful consideration so that its proper role may be identified.

To provide guidance for physicians, individuals and families affected by Alzheimer’s, and the public, the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the Alzheimer’s Association have jointly published the first criteria for the appropriate use of this imaging technology to aid in the diagnosis of people with suspected Alzheimer’s disease.

To develop the new criteria, the Alzheimer’s Association and SNMMI assembled an Amyloid Imaging Taskforce (AIT) consisting of dementia and imaging experts to review the scientific literature and develop consensus recommendations for the clinical use of this promising new technology.

According to the AIT, appropriate candidates for amyloid PET imaging include:

  • Those who complain of persistent or progressive unexplained memory problems or confusion and who demonstrate impairments using standard tests of cognition and memory.
  • Individuals meeting tests for possible Alzheimer’s, but who are unusual in their clinical presentation.
  • Individuals with progressive dementia and atypically early age of onset (before age 65).

Inappropriate candidates for amyloid PET imaging include:

  • Those who are age 65 or older and meet standard definitions and tests for Alzheimer’s, since a positive PET scan would provide little added value.
  • Asymptomatic people or those with a cognitive complaint but no clinical confirmation of impairment.

Amyloid PET imaging is also inappropriate:

  • As a means of determining the severity of dementia.
  • When requested solely based on a family history of dementia or presence of other risk factors for Alzheimer’s, such as the ApoE-e4 gene.
  • As a substitute for genetic testing for mutations that cause Alzheimer’s.
  • For non-medical reasons, such as insurance, legal or employment decisions.

“Our primary goal is to provide healthcare practitioners with the information and options available to provide patients with the best possible diagnosis and care in a cost effective manner,” said Maria Carrillo, Ph.D., Alzheimer’s Association vice president of Medical and Scientific Relations.

Please find the Appropriate Use Criteria for Amyloid PET here.