A high-profile group of researchers collaborated on a nationwide study to determine if positron emission tomography (PET) scans influences clinical management of patients with mild cognitive impairment and dementia.
The multicenter study of more than 11,000 Medicare beneficiaries was managed by American College of Radiology and led by the following research sites/centers:
- UC San Francisco
- Brown University School of Public Health
- Virginia Commonwealth University School of Public Health
- Washington University School of Medicine, St. Louis
- UC Davis School of Medicine
- Kaiser Permanente Division of Research
A first-of-its-kind national study uncovered this form of brain imaging (PET) detects Alzheimer’s related “plaques” significantly influenced clinical management of patients with mild cognitive impairment and dementia.
The study revealed providing clinicians with the results of PET scans that identify amyloid plaques in the brain changed medical management—including the use of medications and counseling—in almost 67% of the cases—more than double what investigators had predicted. Known as amyloid PET imaging alters the diagnosis of the cause of cognitive impairment in more than 33% of study participants.
“We are impressed by the magnitude of these results, which make it clear that amyloid PET imaging can have a major impact on how we diagnose and care for patients with Alzheimer’s disease and other forms of cognitive decline,” said study lead author and principal investigator Gil Rabinovici, MD, Distinguished Professor of Neurology at the UCSF Memory and Aging Center and member of the UCSF Weill Institute for Neurosciences.
Launched in 2016, the four-year Imaging Dementia – Evidence for Amyloid Scanning (IDEAS) study was developed by a team of scientists convened by the Alzheimer’s Association to determine whether learning the results amyloid PET imaging would change medical management and health outcomes of people with memory loss and cognitive decline.
IDEAS recruited nearly 1,000 dementia specialists at 595 sites in the U.S. and enrolled more than 16,000 Medicare beneficiaries with mild cognitive impairment or dementia of uncertain cause. Under their Coverage with Evidence Development policy, the Centers for Medicare & Medicaid Services (CMS) reimbursed amyloid PET scans conducted at 343 facilities and interpreted by more than 700 imaging specialists as part of this clinical study.
Study lead Gil Rabinovici noted “this was a uniquely real-world study that looked at the impact of amyloid PET imaging in community clinics and other non-academic settings, and demonstrates for the first time how much impact this technology has in real-world dementia care.”
Although FDA has approved use of amyloid PET tracers, use of PET imaging to assist with the accurate diagnosis of the cause of an individual’s dementia is not covered by Medicare or health insurance plans—making it unavailable to most of the population needing it!
Maria C. Carrillo, PhD, Alzheimer’s Association chief science officer
Gil Rabinovici, MD, Distinguished Professor of Neurology, UCSF Memory and Aging Center
The trial was funded by the following:
- Alzheimer’s Association
- The American College of Radiology
- Avid Radiopharmaceuticals, Inc. (a wholly owned subsidiary of Eli Lilly and Company)
- General Electric Healthcare; and Life Molecular Imaging (formerly Piramal Imaging).
- PET scans in the study were reimbursed by the Centers for Medicare and Medicaid Services (CMS)