Use of Amyloid PET Scan in Early Diagnosis of Alzheimer’s Disease in a Secondary Care Memory Clinic Niki Schoonenboom, MD PhD1, Mohammed Akarriou, MD2; Kees Kalisvaart, MD, PhD3 1 Department of Neurology, 2 Department of Nuclear Medicine, 3 Department of Geriatrics. Spaarne Gasthuis, Haarlem, the Netherlands AUC criteria MCI (1) en Dementia (2) Background: Biomarkers for Alzheimer’s disease (AD) are of aid in supporting the correct diagnosis in an early stage. In the Netherlands there is quite some experience with the CSF biomarkers amyloid beta 42 and (phosphorylated) tau next to MRI. However, the use of FDG and especially amyloid PET imaging in secondary memory clinics needs to be established. Characteristics of patients (1) Obj cog Alters management Persist/progressive MCI Young (< 70) Amyloid SCI no yes MCI Age (yr) Sex 70 (58-83) 10 F, 9 M MRI/CT Clinical Diagnosis 16/3 1 SCI | 7 MCI | 11 Dementia | 5 dd AD/FTD Aim: Aim is to assess the application of appropiate use (AUC) criteria for amyloid imaging in a secondary memory clinic Reasons to undergo Amyloid PET scan: - Knowledge of underlying pathology MRI/CT not compatible with clinical diagnosis CSF not done* or not fully supporting diagnosis * Several reasons 14 Patients positive for amyloid PET imaging (1 doubtly positive, male 83 yr), 4 negative In all MCI and AD patients the knowledge of amyloid pathology increased certainty and altered management. One patient did not have objective cognitive disturbances (but MRI showed parietal atrophy) AUC criteria for amyloid PET: Objective cognitive impairment AD as possible diagnosis Knowledge of amyloid pathology increases certainty and alters management Patients: Persistent/progressive unexplained MCI Possible AD with unclear presentation Progressive dementia and atypical age of onset (young) (2) Alters manag Young Atypical Amy loid PPA yes AD dd FTD no AD dd depression CAA dd AD Dem dd AD AD/Vasc dem Sec opinion AD Vasc/Tumor/AD doubt Pt 1 V 69yr MMSE 25 PPA Alzheimer’s & dementia 2013, Johnson et al. CSF: Amyloid beta42 507 pg/ML, Tau 640 pg/ML, Ptau 52 Pg/ML Study design: - Secondary memory clinic Retrospective, pilot, descriptive Medical records All patients between November 2016- July 2017 19 patients [18F]flutemetamol PET: amyloid positive or negative Pt 2 M 77yr MMSE 23 AD/FTD Conclusion: Application of a [18F]flutemetamol PET scan in a secondary memory clinic is a helpful add-on diagnostic method for AD when used properly, specifically at young age and in an early stage, when other biomarkers are not conclusive CSF: Amyloid beta42 384 pg/ML, Tau 196 pg/ML, Ptau 28 Pg/ML