News in brief: MBS item covers FDG-PET scans for Alzheimer diagnosis; University investigates allegations of irregularities in brain research papers; Genetic factors may promote migraine via metabolites

14 Oct 2021

MBS item covers PET scans for Alzheimer diagnosis

A new MBS item 61560 will be introduced from 1 November for FDG positron emission tomography for the diagnosis of Alzheimer’s disease.

The new item will allow patients with suspected Alzheimer Disease to access FDG PET, which is more sensitive than single-photon emission computed tomography (SPECT), which would largely be replaced.

The item covers FDG PET quantitative comparison to a normal database, performed for the diagnosis of Alzheimer disease where clinical evaluation by a specialist is equivocal. It specified that 18F-FDG PET would be available where it would assist in the differentiation of Alzheimer disease from other aetiologies; and where differentiating Alzheimer disease from an alternative aetiology would alter the management of the patient.

The listing was recommended by the Medicare Services Advisory Committee (MSAC) in November 2020, which said it recognised that replacing SPECT with FDG PET would align with international clinical guidelines.

MSAC advised that FDG PET should be limited to three scans per lifetime and not more often than once per year, to ensure that it would be used only for diagnosis and not for monitoring. MSAC accepted the proposal from Austin Health to list FDG PET on the MBS at the same fee as SPECT ($605), but warned that some providers might charge more for the service. It therefore recommended that the new item be reviewed after 12 months to monitor any out-of-pocket costs and access issues for patients in rural and remote areas.

The proposal estimated that about 6000 patients a year would be eligible for the FDG PET scans for Alzheimers diagnosis.

Genetic factors may promote migraine via metabolites

Newly discovered genetic factors for migraine could lead the way to new preventative drugs and therapies, according to Queensland University of Technology researchers. Professor Dale Nyholt and a team from the QUT Centre for Genomics and Personalised Health have causal genetic links to three blood metabolite levels that increase migraine risk.

Their findings, published in The American Journal of Human Genetics show that genetic actors  are linked to lower levels of DHA, an omega-3 known to reduce inflammation; higher levels of LPE(20:4), a chemical that blocks the anti-inflammatory molecule anandamide; and lower levels of an uncharacterised metabolite, named X–11315, that increased the risk of migraine. Professor Nyholt said these genetic links could now be targeted by future research and clinical trials to develop and test compounds that influenced metabolite levels and prevented migraine.

“Observed relationships between genetic factors influencing blood metabolite levels and genetic risk for migraine suggest an alteration of metabolites in people with migraine,” Professor Nyholt said.

University investigates allegations of irregularities in brain research papers

The University of NSW says it has launched an investigation into allegations of data and image manipulation in neurodegeneration research studies.

The allegations centre around work by scientists now working at the University of NSW’s Centre for Healthy Brain Ageing, whose work was questioned on the scientific portal PubPeer by science integrity blogger Elisabeth Bik.

According to a report in the Sydney Morning Herald, the claims relate to studies covering topics such as the role of NAD+ in brain ageing, in which critics allege that some images been reused multiple times to represent different findings.

The university said it was aware of the concerns, “and we are managing these concerns in accordance with our research misconduct procedure. It would be inappropriate to comment any further at this stage.”

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