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Study: Brain imaging not accurate or sensitive enough (yet) to detect Alzheimer’s disease in primary care settings

dementia_pet_imagingAccu­ra­cy of demen­tia brain imag­ing must improve (Uni­ver­si­ty of East Anglia release):

A report pub­lished today in The Lancet Neu­rol­o­gy eval­u­ates for the first time how well dif­fer­ent types of brain imag­ing tests work to detect Alzheimer’s and pre­dict how the dis­ease will progress.

The results show that the accu­ra­cy of brain imag­ing must be improved before it can be rolled out on a scale that could be use­ful to health­care providers and patients.

The num­ber of new diag­nos­tic and prog­nos­tic tools for demen­tia is steadi­ly increas­ing and here are a lot of dif­fer­ent scan­ning tech­niques cur­rent­ly being used in clin­i­cal research set­tings. These include dif­fer­ent types of MRI scans, which use strong mag­net­ic fields and radio waves to pro­duce detailed images of the inside of the brain, and Positron Emis­sion Tomog­ra­phy (PET) scans, which use a small amount of a radioac­tive drug, or trac­er, to test how tis­sues in the brain are actu­al­ly func­tion­ing.

We want­ed to find out which pro­ce­dures are use­ful for patients and which ones are not”…The results of this review are promis­ing, but the down­fall is that none of these meth­ods are sen­si­tive or accu­rate enough to be rolled out into pri­ma­ry care. We want to see diag­nos­tic bio­mark­ers with a sen­si­tiv­i­ty of over 90 per cent, and speci­fici­ty near 100 per cent to be reli­able.

They would also need to be non-inva­sive, easy, time effi­cient and inex­pen­sive,” he added.

Study: Mul­ti­modal imag­ing in Alzheimer’s dis­ease: valid­i­ty and use­ful­ness for ear­ly detec­tion (The Lancet Neu­rol­o­gy)

  • Sum­ma­ry: Alzheimer’s dis­ease is a pro­gres­sive neu­rode­gen­er­a­tive dis­ease that typ­i­cal­ly man­i­fests clin­i­cal­ly as an iso­lat­ed amnes­tic deficit that pro­gress­es to a char­ac­ter­is­tic demen­tia syn­drome. Advances in neu­roimag­ing research have enabled map­ping of diverse mol­e­c­u­lar, func­tion­al, and struc­tur­al aspects of Alzheimer’s dis­ease pathol­o­gy in ever increas­ing tem­po­ral and region­al detail. Accu­mu­lat­ing evi­dence sug­gests that dis­tinct types of imag­ing abnor­mal­i­ties relat­ed to Alzheimer’s dis­ease fol­low a con­sis­tent tra­jec­to­ry dur­ing patho­gen­e­sis of the dis­ease, and that the first changes can be detect­ed years before the dis­ease man­i­fests clin­i­cal­ly. These find­ings have fuelled clin­i­cal inter­est in the use of spe­cif­ic imag­ing mark­ers for Alzheimer’s dis­ease to pre­dict future devel­op­ment of demen­tia in patients who are at risk. The poten­tial clin­i­cal use­ful­ness of sin­gle or mul­ti­modal imag­ing mark­ers is being inves­ti­gat­ed in select­ed patient sam­ples from clin­i­cal expert cen­tres, but addi­tion­al research is need­ed before these promis­ing imag­ing mark­ers can be suc­cess­ful­ly trans­lat­ed from research into clin­i­cal prac­tice in rou­tine care.

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