Alzheimer’s Association and Society of Nuclear Medicine and Molecular Imaging (SNMMI) Publish First Guidelines for Brain Amyloid Imaging
http://www.businessweek.com/news/2013-01-28/insurers-urged-to-cover-brain-imaging-for-alzheimer-s
Only recently has it become possible to create high-quality images of the brain plaques characteristic of Alzheimer’s disease in living people through positron emission tomography (PET). Even so, questions remain about what can be learned from these PET images and which people should have this test.
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.
The criteria describe the circumstances where amyloid imaging could potentially be helpful in the diagnosis of people with cognitive impairment, when considered along with other clinical information. According to the new criteria, 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).
Although there are potential benefits, amyloid PET results do not constitute and are not equivalent to a clinical diagnosis of Alzheimer’s disease dementia. Imaging is only one tool among many that clinicians should use judiciously to manage patients, and amyloid PET imaging does not substitute for a careful history and examination. Because both dementia care and amyloid PET technology are in active development, these new appropriate use criteria will require periodic reassessment and updating.
Amyloid imaging is not covered by insurance at this time, and costs for the scan are “out of pocket.” The Centers for Medicare & Medicaid Services (CMS) has convened a meeting this Wednesday, January 30, to review available evidence and hear public testimony on the use of amyloid PET imaging for the management of dementia and neurodegenerative disease. William Thies, Ph.D., Alzheimer’s Association chief medical and scientific officer, will speak at the CMS meeting and present the new amyloid imaging guidelines. The Alzheimer’s Association recommends that CMS consider coverage for PET amyloid imaging based on the new guidelines.
Alzheimer’s Association Involvement
To develop the new brain amyloid imaging 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.
“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.
The criteria were published online today as an article “in press” by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
http://www.optimumseniorcare.com/services/alzheimerscare.php