Diagnosing Alzheimer’s disease or other types of dementia involves the use of medical imaging, including magnetic resonance imaging (MRI) and computed tomography (CT). But these tests are used mostly to rule out other conditions that can cause symptoms similar to those of Alzheimer’s disease. Those conditions may include tumors, strokes, traumatic brain injury, or fluid build-up in the brain.
But the Centers for Medicare and Medicaid Studies (CMS) recently announced a protocol for a four-year, $100 million study under the acronym IDEAS. It stands for Imaging Dementia: Evidence for Amyloid Scanning. Led by the Alzheimer’s Association and managed by the American College of Radiology, the study is designed to find out how well medical imaging of amyloid performs in the real world as opposed to clinical and academic research.
Specifically, IDEAS will help determine whether amyloid scanning can affect diagnosis and management of people who cannot be definitively diagnosed based on clinical signs and symptoms. Nearly 18,500 patient scans from around 200 imaging centers nationwide will be covered under IDEAS.
Who Are Good Candidates for Medical Imaging to Detect Amyloid?
Diagnostic radiology in the form of amyloid scanning alone isn’t sufficient for diagnosing people with cognitive impairment. Other clinical information is essential, and physicians shouldn’t order amyloid scanning unless it would increase diagnostic certainty or potentially alter a treatment plan. Amyloid scanning is done by Positron Emission Tomography (PET), which is expensive. People who are appropriate candidates for amyloid scanning using PET include:
• People who complain of persistent, progressive, unexplained confusion or memory problems and demonstrate these impairments on standard cognition and memory tests
• People who fulfill tests for possible Alzheimer’s, but who have unusual clinical presentations
• People with progressive dementia who are under age 65
Why Isn’t Diagnostic Radiology Routinely Used to Detect Amyloid?
Amyloid plaques in the brain are characteristic of Alzheimer’s disease, but their presence alone is insufficient for diagnosis. Some people with amyloid plaques have no symptoms of cognitive problems. Therefore, medical imaging of amyloid plaques isn’t routinely recommended by radiologists for people suspected of having Alzheimer’s. Although the cost of PET scanners has declined some, and the tracers used in PET have become more widely available (and as new tracers come onto the market), the costs and complexity still make it inadequate as a screening tool.
What Does IDEAS Hope to Accomplish in Terms of Diagnostic Radiology?
The purpose of IDEAS is to find out whether obtaining an amyloid scan can affect diagnosis and management of people who may have Alzheimer’s. Participants hope to learn about how amyloid imaging functions in “real world” scenarios, and how and where it fits in current diagnostic procedures – something that is presently unknown. Study Chair Gil D. Rabinovici, MD, who is also an Associate Professor of Neurology at the University of California, San Francisco, believes that knowledge of amyloid status will “lead to significant changes in patient management – such as earlier counseling and prescription of more appropriate drugs – that will translate into improved long-term outcomes.”
steleRAD Radiologists Stay Current With the Latest Research
The Board-certified owner-operators of SteleRAD make it a point to stay at the leading edge of research on medical imaging, particularly when it could lead to better diagnosis and earlier treatment of devastating illnesses like Alzheimer’s.
Neuroradiology specialists Michael DiGiorgio, MD and Shawn Fibkins, MD know that the key to effective treatment of neurological conditions relies upon the earliest, most accurate diagnosis, and the IDEAS study should help physicians answer some of the questions surrounding amyloid scanning for diagnosing Alzheimer’s disease. To learn more about neuroradiology or any other radiology subspecialties for your hospital, practice, or imaging center, we encourage you to call SteleRAD at 954-358-5250, or contact us online at any time.