April 26, 2012

One of the greatest fears among the elderly and adults approaching advanced age is the loss of cognitive function and memory due to Alzheimer’s disease or other forms of dementia. While it is not uncommon for people without dementia to sometimes forget where they had placed their car keys, other forms of memory loss, cognitive losses, changes in personality, etc., could be warning signs of dementia that often instill enormous fear and concern in people that they are “losing their minds.”

What Is PET?

“PET” is positron emission tomography (PET), a type of scan that is useful in diagnosing many different medical conditions. In 2004, the FDA has approved fluorodeoxyglucose (FDG)-PET for the diagnostic evaluation of dementia, including Alzheimer’s disease.

What Are Amyloids?

PET scans are sometimes used to look for amyloid tracers in the brain. Amyloids are insoluble fibrous protein aggregates that are inappropriately folded versions of proteins and polypeptides that are naturally present in the body. When the abnormal accumulation of amyloid fibrils occurs in various organs of the body, they can lead to serious medical conditions.

Amyloids are associated with more than 20 serious diseases, including Alzheimer’s disease. The amyloid designated as amyloid beta is associated with Alzheimer’s disease but is also involved with other, non-disease activities within the body. Amyloid beta is the main component of amyloid plaques (tangles of amyloid deposits) that are found in the brains of Alzheimer’s disease patients.

Using PET to scan for amyloid tracers, especially with newer amyloid tracers becoming avaliable in the near future, raises issues concerning the effectiveness and accuracy of PET scans in diagnosing Alzheimer’s disease and other forms of dementia.

Misdiagnosis Of Alzheimer’s Disease Based On PET Scan Results

A recent study was conducted to research the prevalence of misdiagnosis of Alzheimer’s disease in patients in which PET scan was used in the diagnosis. The new study found that almost two-thirds of patients were misdiagnosed or had inconclusive data based on the interpretations of their PET scans.

The study involved all patients at the University of Colorado Hospital Neurobehavior Clinic between September, 2004 and September, 2010. Of the 46 patients who had received PET scans, 30 were misdiagnosed or had inconclusive data on the basis of the interpretation of their PET scans, and 16 patients were false-positives (where the PET scans were incorrectly interpreted as indicating Alzheimer’s disease — 9 of the 16 had either normal cognition or a reversible cause of their dementia). Only 11% of the PET scans were interpreted by highly-specialized neuroradiologists.

So What Do The Results Of The Study Mean?

PET scans may be a useful diagnostic tool for Alzheimer’s disease under certain circumstances: “A positive amyloid scan means there is high likelihood of amyloid plaques, but that doesn’t mean a patient has AD [Alzheimer’s disease] as the cause of their symptoms…The scans must be ordered only in certain situations, as an adjunct to a clinical evaluation, cognitive testing, and structural imaging.”


Advancements in medicine and in medical technology promise the hope of earlier diagnosis and possible cure of diseases and the easing of pain in patients. But the use of ever-advancing medical technology requires that it be used in the proper manner and that it be subjected to continuing evaluation and refinement to best serve those that it can help the most.

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