ACR–ACNM–ASNR–SNMMI PRACTICE PARAMETER FOR THE PERFORMANCE OF BRAIN PET/CT IMAGING IN DEMENTIA

PREAMBLE

INTRODUCTION

II.

INDICATIONS

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

IV.

SPECIFICATIONS OF THE EXAMINATION

IV.

SPECIFICATIONS OF THE EXAMINATION

Patient Preparation

IV.

SPECIFICATIONS OF THE EXAMINATION

Radiopharmaceutical

IV.

SPECIFICATIONS OF THE EXAMINATION

Patient Positioning

IV.

SPECIFICATIONS OF THE EXAMINATION

Protocol for CT Imaging

IV.

SPECIFICATIONS OF THE EXAMINATION

Protocol for PET Imaging

IV.

SPECIFICATIONS OF THE EXAMINATION

Interpretation

EQUIPMENT SPECIFICATIONS

VI.

DOCUMENTATION

VII.

EQUIPMENT QUALITY CONTROL

VIII.

RADIATION SAFETY IN IMAGING

IX.

RADIOPHARMACEUTICALS

QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION

ACKNOWLEDGEMENTS

Writing Committee – members represent their societies in the initial and final revision of this practice parameter

ACR
Esposito, Giuseppe MBA, MD, Co-Chair
Tu, Raymond K. MD, MS, Chair
Akin, Esma A MD
Franceschi, Ana M. MD, PhD
Peacock, Justin G MD, PhD

ASNR
Agarwal, Amit MD
Chiang, Gloria C MD
Thaker, Ashesh A MD

SNMMI
Catana, Ciprian MD, PhD
Kuo, Phillip H MD, PhD

ACNM
Colletti, Patrick M. MD
Dhingra, Jitesh MD

Jordan, John E MD, Chair, Commission on Neuroradiology

Larson, David B MBA, MD, Chair, Commission on Quality and Safety

Rohren, Eric MD, PhD, Chair, Commission on Nuclear Medicine & Molecular Imaging

Comments Reconciliation Committee

Kagetsu, Nolan MD - CSC, Co-Chair	Agarwal, Amit MD	Akin, Esma A MD	Catana, Ciprian MD, PhD
Chiang, Gloria C MD	Colletti, Patrick M. MD	Dhingra, Jitesh MD	Esposito, Giuseppe MBA, MD
Franceschi, Ana M. MD, PhD	Jordan, John E MD	Kuo, Phillip H MD, PhD	Larson, David B MBA, MD
Peacock, Justin G MD, PhD	Rohren, Eric MD, PhD	Thaker, Ashesh A MD	Tu, Raymond K. MD, MS

REFERENCES

1. Sosa-Ortiz AL, Acosta-Castillo I, Prince MJ. Epidemiology of dementias and Alzheimer's disease. Arch Med Res. 2012 Nov;43(8):S0188-4409(12)00331-1.
2. Alzheimer's Disease International (ADI) Website. Available at: https://www.alzint.org/.
3. Wimo A, Winblad B, Aguero-Torres H, von Strauss E. The magnitude of dementia occurrence in the world. Alzheimer Dis Assoc Disord. 2003;17(2):63-7.
4. Grand JH, Caspar S, Macdonald SW. Clinical features and multidisciplinary approaches to dementia care. J Multidiscip Healthc. 2011;4():125-47.
5. Alzheimer's Association. 2012 Alzheimer's disease facts and figures. Available at: http://www.alz.org/downloads/facts_figures_2012.pdf.
6. Dubois B, Picard G, Sarazin M. Early detection of Alzheimer's disease: new diagnostic criteria. Dialogues Clin Neurosci. 2009;11(2):135-9.
7. Jack CR, Knopman DS, Jagust WJ, et al. Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade. Lancet Neurol. 2010 Jan;9(1):119-28.
8. Rowe CC, Villemagne VL. Brain amyloid imaging. J Nucl Med. 2011 Nov;52(11):1733-40.
9. Dubois B, Feldman HH, Jacova C, et al. Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurol. 2007 Aug;6(8):734-46.
10. Jack CR, Bennett DA, Blennow K, et al. A/T/N: An unbiased descriptive classification scheme for Alzheimer disease biomarkers. Neurology. 2016 Aug 02;87(5):539-47.
11. Jack CR, Albert MS, Knopman DS, et al. Introduction to the recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011 May;7(3):257-62.
12. Perrin RJ, Fagan AM, Holtzman DM. Multimodal techniques for diagnosis and prognosis of Alzheimer's disease. Nature. 2009 Oct 15;461(7266):916-22.
13. Jack CR, Lowe VJ, Weigand SD, et al. Serial PIB and MRI in normal, mild cognitive impairment and Alzheimer's disease: implications for sequence of pathological events in Alzheimer's disease. Brain. 2009 May;132(Pt 5):1355-65.
14. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's dement.. 7(3):263-9, 2011 May.
15. Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011 May;7(3):270-9.
16. Dubois B, Feldman HH, Jacova C, et al. Revising the definition of Alzheimer's disease: a new lexicon. Lancet Neurol. 2010 Nov;9(11):1118-27.
17. U. S. Department of Health and Human Services. National Coverage Analysis (NCA) for Positron Emission Tomography (FDG) and Other Neuroimaging Devices for Suspected Dementia (CAG-00088R). http://www.cms.gov/medicare-coverage-database/details/nca-details.aspx?NCAId=104&NcaName=Positron+Emission+Tomography+(FDG)+and+Other+Neuroimaging+Devices+for+Suspected+Dementia&NCDId=288&ncdver=3&IsPopup=y&. .
18. Morris JC, Roe CM, Grant EA, et al. Pittsburgh compound B imaging and prediction of progression from cognitive normality to symptomatic Alzheimer disease. Arch Neurol. 2009 Dec;66(12):1469-75.
19. Ossenkoppele R, Smith R, Mattsson-Carlgren N, et al. Accuracy of Tau Positron Emission Tomography as a Prognostic Marker in Preclinical and Prodromal Alzheimer Disease: A Head-to-Head Comparison Against Amyloid Positron Emission Tomography and Magnetic Resonance Imaging. JAMA Neurology. 78(8):961-971, 2021 08 01.
20. Groot C, Smith R, Collij LE, et al. Tau Positron Emission Tomography for Predicting Dementia in Individuals With Mild Cognitive Impairment. JAMA Neurol. 2024 Aug 01;81(8):845-856.
21. Bohnen NI, Djang DS, Herholz K, Anzai Y, Minoshima S. Effectiveness and safety of 18F-FDG PET in the evaluation of dementia: a review of the recent literature. [Review]. J Nucl Med. 53(1):59-71, 2012 Jan.
22. Anchisi D, Borroni B, Franceschi M, et al. Heterogeneity of brain glucose metabolism in mild cognitive impairment and clinical progression to Alzheimer disease. Arch Neurol. 2005 Nov;62(11):1728-33.
23. Berent S, Giordani B, Foster N, et al. Neuropsychological function and cerebral glucose utilization in isolated memory impairment and Alzheimer's disease. J Psychiatr Res. 1999;33(1):7-16.
24. Landau SM, Harvey D, Madison CM, et al. Comparing predictors of conversion and decline in mild cognitive impairment. Neurology. 2010 Jul 20;75(3):230-8.
25. Rabinovici GD, Gatsonis C, Apgar C, et al. Association of Amyloid Positron Emission Tomography With Subsequent Change in Clinical Management Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia. JAMA. 321(13):1286-1294, 2019 04 02.
26. Braak H, Braak E. Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol. 1991;82(4):239-59.
27. American College of Radiology. ACR–ACNM–SNMMI–SPR Practice Parameter for the Use of Radiopharmaceuticals in Diagnostic Procedures. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=171+&releaseId=2
28. American College of Radiology. ACR Practice Parameter for Continuing Medical Education. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=130+&releaseId=2
29. American College of Radiology. ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of PET/CT Imaging Equipment. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=198+&releaseId=2
30. American College of Radiology. ACR–SPR Practice Parameter for Performing and Interpreting Diagnostic Computed Tomography (CT). Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=132+&releaseId=2
31. Fusion imaging: a new type of technologist for a new type of technology. July 31, 2002. J Nucl Med Technol. 2002 Dec;30(4):201-4.
32. Brown RK, Bohnen NI, Wong KK, Minoshima S, Frey KA. Brain PET in suspected dementia: patterns of altered FDG metabolism. [Review][Erratum appears in Radiographics. 2014 Jul-Aug;34(4):8A]. Radiographics. 34(3):684-701, 2014 May-Jun.
33. Eli Lilly and Company. Highlights of Prescribing Information: These highlights do not include all the information needed to use Amyvid safely and effectively. See full prescribing information for Amyvid. Amyvid (Fluorbetapir F 18 injection) for intravenous use. ; Initial U.S. Approval: 2012. https://pi.lilly.com/us/amyvid-uspi.pdf.
34. GE Healthcare. Highlights of Prescribing Information: These highlights do not include all the information needed to use VIZAMYL safely and effectively. See full prescribing information for VIZAMYL. VIZAMYL (flutemetamol F 18 injection) for intravenous use. ; Initial U.S. Approval: 2013.
35. Piramal Imaging. Highlights of Prescribing Information: These highlights do not include all the information needed to use NEURACEQ safely and effectively. See full prescribing information for NEURACEQ. NEURACEQ (florbetaben F 18 injection), for intravenous use. ; Initial U.S. Approval: 2014.
36. American College of Radiology. ACR-ASNR-SPR Practice Parameter for the Performance of Computed Tomography (CT) of the Head. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=76+&releaseId=2
37. American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Findings. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=74+&releaseId=2
38. American College of Radiology. ACR–AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Computed Tomography (CT) Equipment. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=131+&releaseId=2
39. Eli Lilly and Company. HIGHLIGHTS OF PRESCRIBING INFORMATION: These highlights do not include all the information needed to use TAUVID safely and effectively. See full prescribing information for TAUVID. TAUVID™ (flortaucipir F 18 injection), for intravenous use. Initial U.S. Approval: 2020. Available at: https://pi.lilly.com/us/tauvid-uspi.pdf.

Appendix A