Supplementary Material for: Effect of Amyloid Imaging on the Diagnosis and Management of Patients with Cognitive Decline: Impact of Appropriate Use Criteria

<b><i>Background:</i></b> Published appropriate use criteria (AUC) describe patients for whom amyloid positron emission tomography (PET) might be most useful. This study compared the impact of amyloid PET on diagnosis and management in subjects likely to either meet or not meet AUC. <b><i>Methods:</i></b> Physicians provided a provisional diagnosis and management plan for patients presenting with cognitive decline before and after amyloid PET imaging with florbetapir F 18. Participants were classified as AUC-like or not, based on the prescan diagnosis and demographic features. <b><i>Results:</i></b> In all, 125 of 229 participants (55%) were classified as AUC-like. Sixty-two percent of the AUC-like subjects had a change in diagnosis after scanning compared with 45% of the non-AUC subjects (p = 0.011). Both groups demonstrated high rates of change in their management plans after scanning (88.0% for AUC-like cases, 85.6% for non-AUC cases). <b><i>Conclusions:</i></b> The impact of amyloid imaging on diagnosis and planned management was maintained and, if anything, amplified in AUC-like patients.

背景：已发表的适宜使用标准（appropriate use criteria, AUC）明确了淀粉样蛋白正电子发射断层扫描（positron emission tomography, PET）的最优适用人群。本研究对比了淀粉样蛋白PET检查对符合或不符合AUC的受试者在诊断与诊疗管理方面的影响。
方法：医师需为出现认知减退的患者，在接受氟贝他匹F-18标记的淀粉样蛋白PET成像前后，分别出具初步诊断与诊疗计划。本研究基于扫描前的诊断结果与人口统计学特征，将受试者划分为AUC适配组与非AUC适配组。
结果：总计229名受试者中，125名（55%）被归入AUC适配组。扫描后，AUC适配组中有62%的受试者诊断结果发生变更，而非AUC适配组的该比例为45%（p=0.011）。两组受试者的诊疗计划在扫描后均呈现较高的变更率：AUC适配组为88.0%，非AUC适配组为85.6%。
结论：淀粉样蛋白成像对诊断与预设诊疗方案的影响在AUC适配组患者中不仅得以维持，甚至进一步增强。