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CCCDTD5: Clinical role of neuroimaging and liquid biomarkers in patients with cognitive impairment

Authors: Brisson MBrodeur CLétourneau-Guillon LMasellis MStoessl JTamm AZukotynski KIsmail ZGauthier SRosa-Neto PSoucy JP


Affiliations

1 Centre hospitalier de l'université de Québec Quebec City Canada.
2 Institut universiatire de gériatrie de Montréal Montreal Canada.
3 Centre hospitalier de l'université de Montréal Montreal Canada.
4 Sunnybrook Health Sciences Centre Toronto Canada.
5 Vancouver Coastal Health, University of British-Columbia Vancouver Canada.
6 University of Alberta Edmonton Canada.
7 McMaster University Hamilton Canada.
8 Department of Psychiatry, Hotchkiss Brain Institute and O'Brien Institute for Public Health University of Calgary Calgary Canada.
9 McGill Center for Studies in Aging Canada.
10 McConnell Brain Imaging Centre, Montreal Neurological Institute Montreal Canada.
11 PERFORM Center, Concordia University Montreal Canada.

Description

Since 1989, four Canadian Consensus Conferences on the Diagnosis and Treatment of Dementia (CCCDTDs) have provided evidence-based dementia diagnostic and treatment guidelines for Canadian clinicians and researchers. We present the results from the Neuroimaging and Fluid Biomarkers Group of the 5th CCCDTD (CCCDTD5), which addressed topics chosen by the steering committee to reflect advances in the field and build on our previous guidelines. Recommendations on Imaging and Fluid Biomarker Use from this Conference cover a series of different fields. Prior structural imaging recommendations for both computerized tomography (CT) and magnetic resonance imaging (MRI) remain largely unchanged, but MRI is now more central to the evaluation than before, with suggested sequences described here. The use of visual rating scales for both atrophy and white matter anomalies is now included in our recommendations. Molecular imaging with [18F]-fluorodeoxyglucose ([18F]-FDG) Positron Emisson Tomography (PET) or [99mTc]-hexamethylpropyleneamine oxime/ethylene cysteinate dimer ([99mTc]-HMPAO/ECD) Single Photon Emission Tomography (SPECT), should now decidedly favor PET. The value of [18F]-FDG PET in the assessment of neurodegenerative conditions has been established with greater certainty since the previous conference, and it has now been recognized as a useful biomarker to establish the presence of neurodegeneration by a number of professional organizations around the world. Furthermore, the role of amyloid PET has been clarified and our recommendations follow those from other groups in multiple countries. SPECT with [123I]-ioflupane (DaTscanTM) is now included as a useful study in differentiating Alzheimer's disease (AD) from Lewy body disease. Finally, liquid biomarkers are in a rapid phase of development and, could lead to a revolution in the assessment AD and other neurodegenerative conditions at a reasonable cost. We hope these guidelines will be useful for clinicians, researchers, policy makers, and the lay public, to inform a current and evidence-based approach to the use of neuroimaging and liquid biomarkers in clinical dementia evaluation and management.


Links

PubMed: https://pubmed.ncbi.nlm.nih.gov/33532543/

DOI: 10.1002/trc2.12098