Supplementary Material for: Effectiveness of Florbetapir PET Imaging in Changing Patient Management

Aims: To evaluate the impact of amyloid PET imaging on
diagnosis and patient management in a multicenter, randomized,
controlled study. Methods: Physicians identified patients
seeking a diagnosis for mild cognitive impairment or dementia, possibly
due to Alzheimer disease (AD), and recorded a working diagnosis and a
management plan. The patients underwent florbetapir PET scanning and
were randomized to either immediate or delayed (1-year) feedback
regarding amyloid status. At the 3-month visit, the physician updated
the diagnosis and recorded a summary of the actual patient management
since the post-scan visit. The study examined the impact of immediate
versus delayed feedback on patient diagnosis/management at 3 and 12
months. Results: A total of 618 subjects were randomized
(1:1) to immediate or delayed feedback arms, and 602 subjects completed
the 3-month primary endpoint visit. A higher proportion of patients in
the immediate feedback arm showed a change in diagnosis compared to the
controls (32.6 vs. 6.4%; p = 0.0001). Similarly, a higher
proportion of patients receiving immediate feedback had a change in
management plan (68 vs. 55.5%; p < 0.002), mainly driven by
changes in AD medication. Specifically, acetylcholinesterase inhibitors
were prescribed to 67% of the amyloid-positive and 27% of the
amyloid-negative subjects in the information group compared with 56 and
43%, respectively, in the control group (p < 0.0001). These between-group differences persisted until the 12-month visit. Conclusion: Knowledge of the amyloid status affects the diagnosis and alters patient management.