Interdisciplinary Center for Health Technology Assessment and Public Health, University of Erlangen-Nuremberg, National Cluster of Excellence 'Medical Technologies - Medical Valley EMN', Erlangen, Germany.
Dement Geriatr Cogn Disord. 2013;36(5-6):263-78. doi: 10.1159/000351679. Epub 2013 Aug 16.
BACKGROUND/AIMS: Healthcare systems face an increased prevalence of Alzheimer's disease and increasing costs. The use of molecular biomarkers and imaging could offer an effective solution for these issues. The objective of this study was to assess amyloid imaging regarding clinical utility and impact.
A literature search was performed in several databases, searching articles between 2008 and January 2013 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The results are reported according to the clinical correlates of amyloid imaging.
Thirty-three studies were included in the final analysis. Five studies evaluated amyloid imaging for diagnosis. Nine studies assessed the prognostic value. Twenty-two studies provided correlations to cognitive measures. Amyloid imaging provides a high reliability in diagnosis and prognosis, but cognitive measures only showed weak correlations.
The evidence clearly indicated that amyloid imaging has not arrived yet in clinical practice. However, it can provide substantial benefits in special aspects of diagnostic accuracy and for a diagnosis up to 10 years before clinical diagnosis. This can be a base for early preventive treatment strategies such as anti-amyloid therapy. In this context, amyloid imaging is crucial to understand the early pathologic process in Alzheimer's disease.
背景/目的：医疗保健系统面临着阿尔茨海默病发病率上升和成本增加的问题。分子生物标志物和影像学的应用可能为这些问题提供有效的解决方案。本研究的目的是评估淀粉样蛋白成像的临床实用性和影响。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，在多个数据库中进行了文献检索，搜索了 2008 年至 2013 年 1 月期间的文章。结果根据淀粉样蛋白成像的临床相关性进行报告。
最终分析纳入了 33 项研究。五项研究评估了淀粉样蛋白成像在诊断方面的应用。九项研究评估了预后价值。二十二项研究提供了与认知测量的相关性。淀粉样蛋白成像在诊断和预后方面具有高度可靠性，但认知测量仅显示出较弱的相关性。
证据清楚地表明，淀粉样蛋白成像尚未在临床实践中得到应用。然而，它可以在诊断准确性的某些方面提供实质性的益处，并且可以在临床诊断前 10 年进行诊断。这可以为早期预防治疗策略（如抗淀粉样蛋白治疗）提供基础。在这种情况下，淀粉样蛋白成像对于了解阿尔茨海默病的早期病理过程至关重要。
