Based on a review of these articles, there are two conclusions. 1) Publications since the prior TA do not provide evidence supporting revised estimates of the operating characteristics of PET for discriminating AD from other competing diagnoses. 2) Three studies suggest FDG-PET could be valuable for distinguishing patients with MCI who rapidly convert to frank AD. Two were relatively small studies that require validation and assessment of incremental value above conventional clinical measures. A third, larger study of FDG PET for prediction of progression for patients with MCI also suggests a potential role for PET in predicting clinical course for patients with dementia. However, this study did not comment on findings for patients with AD only, and results for PET, while suggestive of higher sensitivity and specificity, did not differ in a statistically significant manner from clinical findings.
In addition, CMS requested that the Duke EPC review and summarize in the form of an annotated bibliography, the existing scientific evidence with regard to the role of single-photon emission CT (SPECT), volumetric assessment by computed tomography or magnetic resonance imaging (Volumetric CT/MRI), functional magnetic resonance imaging (fMRI), and magnetic resonance spectroscopy (MRS) in the diagnosis, prognosis and estimates of responsiveness to treatment for patients with cognitive abnormalities. Of 472 articles initially identified for abstract review, 12 articles for SPECT, 9 for Volumetric CT/MRI, 2 for fMRI, and 4 for MRS eventually met all inclusion criteria and are summarized as an annotated bibliography.