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

Background: 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. Methods: 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. Results: 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). Conclusions: The impact of amyloid imaging on diagnosis and planned management was maintained and, if anything, amplified in AUC-like patients.背景：已发布的适宜使用标准（appropriate use criteria, AUC）界定了淀粉样蛋白正电子发射断层扫描（positron emission tomography, PET）应用价值最高的患者人群。本研究对比了淀粉样蛋白PET成像对符合与不符合AUC的受试者在诊断与诊疗管理上的影响。 方法：医师为存在认知减退的患者在接受氟贝他匹F18（florbetapir F 18）标记的淀粉样蛋白PET成像前后，分别提供初步诊断与诊疗方案。基于扫描前的诊断结果与人口统计学特征，受试者被划分为AUC匹配组与非AUC匹配组。 结果：总计229名受试者中，有125名（55%）被归入AUC匹配组。AUC匹配组中有62%的受试者在成像后诊断发生变更，而非AUC匹配组的这一比例为45%（p=0.011）。两组受试者在成像后的诊疗方案变更率均较高：AUC匹配组为88.0%，非AUC匹配组为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匹配组患者中得以维持，甚至进一步增强。