ACR Appropriateness Criteria® Dementia

Expert Panel on Neurological Imaging

Research output: Contribution to journalArticle

Abstract

Degenerative disease of the central nervous system is a growing public health concern. The primary role of neuroimaging in the workup of patients with probable or possible Alzheimer disease has typically been to exclude other significant intracranial abnormalities. In general, the imaging findings in structural studies, such as MRI, are nonspecific and have limited potential in differentiating different types of dementia. Advanced imaging methods are not routinely used in community or general practices for the diagnosis or differentiation of forms of dementia. Nonetheless, in patients who have been evaluated by a dementia expert, FDG-PET helps to distinguish Alzheimer disease from frontotemporal dementia. In patients with suspected dementia with Lewy bodies, functional imaging of the dopamine transporter (ioflupane) using SPECT may be helpful. In patients with suspected normal-pressure hydrocephalus, DTPA cisternography and HMPAO SPECT/CT brain may provide assessment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)S100-S112
JournalJournal of the American College of Radiology
Volume17
Issue number5
DOIs
StatePublished - May 2020

Keywords

  • AUC
  • Alzheimer disease
  • Appropriate Use Criteria
  • Appropriateness Criteria
  • Cognitive decline
  • Dementia with Lewy body
  • Frontotemporal dementia
  • Suspected idiopathic normal-pressure hydrocephalus
  • Vascular dementia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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