Amyloid PET ordering practices in a memory disorders clinic

Abstract

AbstractBackgroundThe objective of the current study was to assess amyloid PET scan ordering practices in a Veterans Affairs memory disorders clinic, where such scans are readily available, and the extent to which amyloid PET ordering may occur in memory disorders clinics if covered by insurance in the future.MethodsUsing retrospective chart review over a three‐year period, we compared patient demographic, clinical, and MRI structural features that were predictive of ordering an amyloid PET scan in a memory disorders clinic to those of patients who did not have one ordered. The percentage of patients who met previously published appropriate use criteria were evaluated.ResultOverall 34.9% of patients received an amyloid PET scan as part of their diagnostic workup and 97.9% of these ordered scans were consistent with appropriate use criteria. Patients who received an amyloid PET were younger on average and more likely to have an initial diagnosis of suspected AD. Overall, 64.4% of patients without an amyloid PET scan ordered would have met appropriate use criteria for amyloid PET. Thus, fewer patients received an amyloid PET scan than were eligible according to current appropriate use criteria.ConclusionA little more than a third of veterans in a memory disorders clinic received an amyloid PET scan as part of their diagnostic work up when ordering was freely available to cognitive behavioral neurologists and not constrained by third‐party reimbursement. The vast majority of amyloid PET scans ordered were consistent with current appropriate use criteria. Future versions of the appropriate use criteria for amyloid PET could address ordering in patients with subjective cognitive decline with behavioral/functional impairments as well as patients under consideration for possible anti‐amyloid therapy treatment with Aducanumab and other medications in this class.