Positron emission tomography (PET) imaging of brain amyloid beta is now
clinically available in several countries including the United States and
the United Kingdom, but not Canada. It has become an established technique
in the field of neuroimaging of aging and dementia, with data incorporated
in the new consensus guidelines for the diagnosis of Alzheimer disease and
predementia Alzheimer’s disease–related conditions. At this point, there are
three US Food and Drug Administration– and European Union–approved tracers.
Guided by appropriate use criteria developed in 2013 by the Alzheimer’s
Association and the Society of Nuclear Medicine and Molecular Imaging, the
utility of amyloid imaging in medical practice is now supported by a growing
body of research. In this paper, we aimed to provide an update on the 2012
Canadian consensus guidelines to dementia care practitioners on proper use
of amyloid imaging. We also wished to generate momentum for the industry to
submit a new drug proposal to Health Canada. A group of local, national, and
international dementia experts and imaging specialists met to discuss
scenarios in which amyloid PET could be used appropriately. Peer-reviewed
and published literature between January 2004 and May 2015 was searched.
Technical and regulatory considerations pertaining to Canada were
considered. The results of a survey of current practices in Canadian
dementia centers were considered. A set of specific clinical and research
guidelines was agreed on that defines the types of patients and clinical
circumstances in which amyloid PET could be used in Canada. Future research
directions were also outlined, notably the importance of studies that would
assess the pharmaco-economics of amyloid imaging.