Dementia cases are about to skyrocket—how will this affect imaging demand?

Recent projections on the expected rise of dementia diagnoses could lead to an unprecedented demand for nuclear imaging.  

A new study published in Nature Medicine estimates that cases of dementia will double in the United States over the next four decades, likely surpassing one million diagnoses annually. These findings have spurred many conversations among the imaging community about how the uptick in cases could affect demand. 

Phillip Kuo, MD, PhD, FACR, with the City of Hope Cancer Center in Duarte, California, acknowledges that this will inevitably expand the need for PET imaging services, but suggests imaging will also play a big role in improving outcomes. 

“Both the aging and growing U.S. population will result in a critical increase in the prevalence of dementia in the U.S., but there is hope that we can bend and hopefully reverse that trend,” Kuo tells Health Imaging. “Imaging will undoubtedly play a critical role in making that hope a reality.” 

Amyloid vs. tau imaging

Kuo points to recent and ongoing clinical trials as proof that PET imaging has been solidified as a cornerstone in the diagnosis and management of cognitive disorders. He adds that, while much of experts’ focus has been on amyloid imaging to monitor buildup of the protein, greater emphasis may soon be placed on the presence of tau on PET scans, as it can serve as a barometer for gauging treatment success.

“Tau PET imaging is playing an increasing role in the staging of Alzheimer’s disease and selection of patients for trials. Indeed, while amyloid accumulation in the brain occurs first, tau accumulation tracks more closely with clinical disease progression,” Kuo explains. “By ensuring the proper selection of patients for the approved and future therapies, PET imaging ensures that only the patients with potential for benefit get treated.” 

In line with Kuo’s assessment, the criteria for both amyloid and tau imaging were just updated for the first time in over a decade. The updated criteria—the result of a collaboration between the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the Alzheimer’s Association—reflect the numerous developments in the field of Alzheimer’s research and care, including new nuclear imaging techniques and the approval of multiple treatments capable of slowing the progression of the neurodegenerative disease. The new AUC define 17 specific clinical scenarios, guiding providers on situations when imaging is either “appropriate,” “uncertain” or “rarely appropriate” for both amyloid and tau studies.