Other clinical conditions studied with amyloid PET include vascular dementia, cerebral amyloid angiopathy, Parkinson’s disease dementia, and DLB, but a detailed discussion of results selleck Imatinib in those conditions is beyond the scope of this article (see [105] for a more detailed review). Amyloid positron emission tomography in clinical practice: unresolved questions and recommendations Amyloid imaging represents a promising technique in the evaluation of dementia but many ill-defined factors can probably impact its diagnostic validity and utility [106]. Currently, the only country where amyloid imaging is approved by government authorities is the USA. Clinicians from nearby countries such as Canada may therefore be called upon to interpret results from amyloid tests performed on their patients.

Physicians should be very cautious in their interpretation because, used in isolation, this test cannot diagnose AD or MCI, or differentiate normal from abnormal aging. Recommendations are that the physicians consult with a dementia specialist familiar with this technique when confronted with amyloid imaging reports for studies performed in a region where they are available. Should amyloid imaging become more widely available, it is unlikely to become a routine test. Rather, it will probably be part of a comprehensive evaluation for complex and atypical cases referred to tertiary-care memory clinics when a more accurate clinical diagnosis is needed.

Although surveys suggest that rates of cholinesterase prescription in people with AD range from about 10 to 50% depending on the country, it is our clinical impression that inhibitors are prescribed to a large number of patients with non-AD dementia unlikely to benefit from such Entinostat therapy, while certain populations that could indeed benefit remain untreated (for example, MCI due to AD). A decision to treat might be arrived selleck chem at in a more rational fashion if amyloid PET was applied in the right circumstances, such as in atypical cognitive disorders and dementias [106]. This application could possibly result in significant savings, but further cost-effectiveness studies are required. The more immediate impact of amyloid imaging, however, will probably be improving clinical trial design by enrolling patients based on biological, rather than clinical, phenotype. A positive amyloid scan could well become the primary inclusion criterion for a study focused on prevention of AD progression. Since the CCCDTD4 meeting, an important consensus paper has been published by the Amyloid Imaging Taskforce to provide guidance to dementia care practitioners, patients, and caregivers on appropriate use of amyloid PET [107].