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Table 1 Clinical and research utility of amyloid imaging

From: Amyloid imaging in the differential diagnosis of dementia: review and potential clinical applications

Potential clinical utility
1. Determine whether MCI is due to AD
2. Differentiate AD from non-AD dementia (for example, frontotemporal lobar degeneration), particularly in early age-at-onset patients
3. Determine whether AD copathology is present in patients with cognitive impairment and other known neurologic disease (for example, Parkinson's disease, stroke/vascular disease, multiple sclerosis, epilepsy, HIV)
4. Differentiate AD from nondegenerative cognitive decline (for example, depression, substance abuse)
5. Determine whether AD is present in patients with advanced dementia and no reliable history
6. Identify whether AD is present in focal cortical syndromes (for example, posterior cortical atrophy, primary progressive aphasia, corticobasal syndrome)
7. Differentiate cerebral amyloid angiopathy from intracranial hemorrhage due to small-vessel vasculopathy
Unlikely to have clinical utility
1. Initial investigation of cognitive complaints (in the absence of a detailed neurologic evaluation and cognitive testing)
2. Differentiate AD from other amyloid-beta-associated dementia (for example, dementia with Lewy bodies, cerebral amyloid angiopathy)
3. Differentiate between AD clinical variants (for example, classic amnestic AD vs. posterior cortical atrophy or logopenic variant primary progressive aphasia)
4. Differentiate between non-AD causes of dementia (for example, molecular subtypes of frontotemporal lobar degeneration)
Utility for research only
1 Testing and longitudinal follow-up of asymptomatic or subjective cognitive impairments not meeting MCI criteria or at-risk individuals (for example, gene mutation carriers, family history of AD, apolipoprotein E ε4 allele)
2 Selection of candidates for anti-amyloid treatment trials (AD, MCI, preclinical)
3 Study of the natural evolution of amyloid burden and its role in the pathophysiology of AD and other dementias
4 Potential surrogate marker for anti-amyloid therapies
  1. In all situations, structural imaging using magnetic resonance imaging is recommended to rule out space-occupying lesions, inflammation, or other confounding conditions. AD, Alzheimer's disease; MCI, mild cognitive impairment.