Critical review of the Appropriate Use Criteria for amyloid imaging: Effect on diagnosis and patient care

Abstract

Abstract Introduction The utility of the Appropriate Use Criteria (AUC) for amyloid imaging is not established. Methods Fifty‐three cognitively impaired patients with clinical F 18 ‐florbetapir imaging were classified as early and late onset, as well as AUC‐consistent or AUC‐inconsistent. Chi‐square statistics and t test were used to compare demographic characteristics and clinical outcomes as appropriate. Results Early‐onset patients were more likely to be amyloid positive. Change in diagnosis was more frequent in late‐onset cases. Change in therapy was more common in early‐onset cases. AUC‐consistent and AUC‐inconsistent cases had comparable rates of amyloid positivity. We saw no difference in the rate of treatment changes in the AUC‐consistent group as opposed to the AUC‐inconsistent group. Discussion The primary role of amyloid imaging in the early‐onset group was to confirm the clinically suspected etiology, and in the late‐onset group in detecting amyloid‐negative cases. The rate of therapeutic changes was significantly greater in the early‐onset cases.