Anything But Forgotten: Advancements in Alzheimer’s Early Diagnosis

In 2014, researchers at Rush University discovered that the annual number of deaths each year due to Alzheimer’s disease in the U.S. among people at least 75 years of age is about 500,000. Just 84,000 are typically reported on death certificates.

This means that Alzheimer’s is actually far more widespread than most of us believe, which makes it beneficial to consider taking a second look at our methods for Alzheimer’s diagnosis.

There have been a lot of innovations over the years throughout the medical field. One hot issue in particular–the one we address in this piece–is Alzheimer’s disease. As more and more people succumb to the illness, the importance of early diagnosis has grown exponentially. Fortunately, much hard work has been put into Alzheimer’s diagnosis.

It is fairly standard to use MRI and CT to help diagnose Alzheimer’s disease. These modalities both bring good things to the table when it comes to diagnosis, and they heralded a revolution in the world of radiology several decades ago when the anatomic images they produced made all the difference. In fact, these images continue to improve in quality and convenience today, and are very much relevant.

But what’s on the horizon for the industry in regards to Alzheimer’s? What better technologies are around right now that you and your facility can take advantage of?

Some of the most recent advancements in Alzheimer’s awareness include molecular imaging, advanced image fusion (of CTs, MRIs, PET scans, and more), and blood testing for cross-correlation.

Molecular Imaging

MRI and CT both continue to add an incredible amount of value and insight to imaging. However, they only image anatomy. With molecular imaging, we are able to see what is happening at a molecular level–it allows us to image the actual disease process.

Some of the more advanced technologies available or in development today are nuclear imaging using PET or SPECT imaging, optical imaging, magnetic imaging with MRI, and ultrasound imaging.

“When we look at what the future of identifying earlier stages or before any symptoms [of Alzheimer’s] appear, we are looking at imaging that doesn’t just image organs but functions, and that’s what MRI and CT are really good at identifying; brain structure, anatomy, pathology,” Breda Drury, clinical specialist with Novarad, said.

“It is this progress in advanced imaging, such as molecular imaging, that is focused on moving away from first generation imaging to second generation, if you will, of brain function, reaction, and stimuli.  So for example, if you want to see how somebody who had prolonged drug use has been affected, their brain chemicals will look much different from someone who never used. Advanced imaging can enable this.”

PET imaging in particular is a promising and powerful tool in the imaging repertoire. It can see changes in tumors much sooner than a CAT scan or MRI, and it is increasingly being recognized for its prowess in neuro care.

For more information on molecular imaging in the future of radiology, read this excellent article from MedicalMegaTrends.com.

Image Fusion

Because Alzheimer’s can be diagnosed both by analysis of functional or structural changes in the brain seen by PET and structural changes more easily seen by MRI, it can prove beneficial to fuse these images to achieve a more complete view of the brain.

Nowadays, PACS vendors usually have an option for image fusion–unfortunately, you will more likely than not have to pay extra for it as an add-on. Luckily some systems, like NovaPACS, actually include it, no need to pay extra.

Read more about image fusion here at Applied Radiology.

Blood Testing

It was discovered a few years back that the protein AB42 is produced in great quantities in Alzheimer’s patients. Therefore, increased levels of AB42 in the blood of at-risk individuals has been used as a form of early diagnosis for Alzheimer’s disease.

It was more recently discovered, however, that blood testing is far more effective when combined with cross correlation, which we address next.

For more information on blood testing, this studyshutterstock_342851510 (1) with News Medical can tell you the whole story.

Cross Correlation

No one modality will give you all the information you need when it comes to Alzheimer’s. You must engage in cross correlation in order to obtain the most accurate and complete diagnosis. For example, if you see something in a SPECT and you are unsure, you can cross correlate that image with a blood test to determine and increased or decreased likelihood for Alzheimer’s.

For Alzheimer’s in particular, combining PET scans with blood tests or spinal fluid tests can potentially provide the earliest detection possible at this time. This could help patients to receive treatments before the symptoms of Alzheimer’s even begin, and that’s a win-win situation.

The role of a suitable PACS system

An all-inclusive PACS system, like NovaPACS, gives you the capability to view not just DICOM images, but allows you to import any graphical information for cross-correlation of the findings seen in images.

Additionally, we offer image fusion within the PACS. Many vendors will try to charge providers extra for this function, calling it an “add-on”, but NovaPACS actually includes it.

For example, if a patient had a PET of the brain and a CT of the brain, this function would allow you to fuse those images together quickly with one click of a button.

With NovaPACS, you would get the following benefits: no extra costs for image fusion; the ability to view all SPECT, PET, and any other type of images, even to the point of graphical representations of nuclear medicine and even retinal scans; the ability to import patient diagrams, and more.

If your vendor doesn’t provide these things, or charges your facility extra for them, we urge you to set aside a few minutes and speak with one of our clinical experts as soon as possible. You could be overpaying for your software and missing out on extremely beneficial features. Please click here to get in touch with us!

This post was written by Kristi Alvarado, a marketing and PR specialist with Novarad, with the help of Breda Drury, a clinical specialist at Novarad.

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