{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:16:23Z","timestamp":1783322183798,"version":"3.54.6"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K76AG088554"],"award-info":[{"award-number":["K76AG088554"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Anti\u2014amyloid\u2010\u03b2 (A\u03b2) therapies are reshaping Alzheimer's disease (AD) management. Understanding changes in real\u2010world patterns of diagnostic testing and infusion chair usage is essential for optimizing access to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Retrospective analysis of Mayo Clinic enterprise electronic health records (Jan 2019\u2013Mar 2025) assessed trends in AD\u2010relevant brain imaging, fluid biomarkers, apolipoprotein E (APOE) testing, and lecanemab infusions. Rates of amyloid\u2010beta (A\u03b2) positivity by sex and age,\n                      <jats:italic>APOE<\/jats:italic>\n                      genotype frequencies, and lecanemab treatment initiation and discontinuation were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Following national insurance coverage changes, lecanemab infusions grew by 110 infusions per quarter to 605 in Q1 2025. A\u03b2 positron emission tomography scans increased (+22\/quarter), cerebrospinal fluid biomarker orders declined (\u221225\/quarter), and plasma p\u2010tau\n                      <jats:sub>217<\/jats:sub>\n                      orders rapidly increased (+238\/quarter). Females were more likely to be A\u03b2 positive (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.006).\n                      <jats:italic>APOE<\/jats:italic>\n                      \u2010\u03b54 homozygotes were less likely to initiate lecanemab (HR\u00a0=\u00a00.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>The adoption of anti\u2010A\u03b2 therapies coincided with a rapid shift in diagnostic workflows.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71343","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:30:46Z","timestamp":1775665846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health system patterns of imaging and fluid biomarker testing in the era of anti\u2010amyloid therapies"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8952-7719","authenticated-orcid":false,"given":"W. Hudson","family":"Robb","sequence":"first","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurkiran","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ba","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford H.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher T.","family":"Conyers","sequence":"additional","affiliation":[{"name":"Center for Individualized Medicine Mayo Clinic  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Grilli","sequence":"additional","affiliation":[{"name":"Center for Individualized Medicine Mayo Clinic  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Upjohn","sequence":"additional","affiliation":[{"name":"Center for Individualized Medicine Mayo Clinic  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor E.","family":"Ortega","sequence":"additional","affiliation":[{"name":"Center for Individualized Medicine Mayo Clinic  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Hohman","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Neurology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Keegan","sequence":"additional","affiliation":[{"name":"Life Molecular Imaging  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephraim E.","family":"Parent","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Jacksonville  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrice M.","family":"Cogswell","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Graff\u2010Radford","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Ramanan","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3322-9114","authenticated-orcid":false,"given":"Mary Ellen","family":"Koran","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05485-y"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/13872877251372129"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjpad.2025.100150"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2023.30"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7586"},{"key":"e_1_2_8_7_1","unstructured":"SellergrenA KazemzadehS JaroensriT et\u00a0al.MedGemma Technical Report.arXiv. 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