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Diagnostic Accuracy of Amyloid versus 18 F-Fluorodeoxyglucose Positron Emission Tomography in Autopsy-Confirmed Dementia.
Lesman-Segev, Orit H; La Joie, Renaud; Iaccarino, Leonardo; Lobach, Iryna; Rosen, Howard J; Seo, Sang Won; Janabi, Mustafa; Baker, Suzanne L; Edwards, Lauren; Pham, Julie; Olichney, John; Boxer, Adam; Huang, Eric; Gorno-Tempini, Marilu; DeCarli, Charles; Hepker, Mackenzie; Hwang, Ji-Hye L; Miller, Bruce L; Spina, Salvatore; Grinberg, Lea T; Seeley, William W; Jagust, William J; Rabinovici, Gil D.
Afiliación
  • Lesman-Segev OH; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • La Joie R; Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel.
  • Iaccarino L; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Lobach I; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Rosen HJ; Epidemiology and Biostatistics Department, University of California, San Francisco, San Francisco, CA, USA.
  • Seo SW; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Janabi M; Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  • Baker SL; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
  • Edwards L; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
  • Pham J; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Olichney J; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Boxer A; Alzheimer's Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA.
  • Huang E; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Gorno-Tempini M; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • DeCarli C; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Hepker M; Alzheimer's Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA.
  • Hwang JL; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Miller BL; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Spina S; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Grinberg LT; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Seeley WW; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Jagust WJ; Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • Rabinovici GD; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
Ann Neurol ; 89(2): 389-401, 2021 02.
Article en En | MEDLINE | ID: mdl-33219525
ABSTRACT

OBJECTIVE:

The purpose of this study was to compare the diagnostic accuracy of antemortem 11 C-Pittsburgh compound B (PIB) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) versus autopsy diagnosis in a heterogenous sample of patients.

METHODS:

One hundred one participants underwent PIB and FDG PET during life and neuropathological assessment. PET scans were visually interpreted by 3 raters blinded to clinical information. PIB PET was rated as positive or negative for cortical retention, whereas FDG scans were read as showing an Alzheimer disease (AD) or non-AD pattern. Neuropathological diagnoses were assigned using research criteria. Majority visual reads were compared to intermediate-high AD neuropathological change (ADNC).

RESULTS:

One hundred one participants were included (mean age = 67.2 years, 41 females, Mini-Mental State Examination = 21.9, PET-to-autopsy interval = 4.4 years). At autopsy, 32 patients showed primary AD, 56 showed non-AD neuropathology (primarily frontotemporal lobar degeneration [FTLD]), and 13 showed mixed AD/FTLD pathology. PIB showed higher sensitivity than FDG for detecting intermediate-high ADNC (96%, 95% confidence interval [CI] = 89-100% vs 80%, 95% CI = 68-92%, p = 0.02), but equivalent specificity (86%, 95% CI = 76-95% vs 84%, 95% CI = 74-93%, p = 0.80). In patients with congruent PIB and FDG reads (77/101), combined sensitivity was 97% (95% CI = 92-100%) and specificity was 98% (95% CI = 93-100%). Nine of 24 patients with incongruent reads were found to have co-occurrence of AD and non-AD pathologies.

INTERPRETATION:

In our sample enriched for younger onset cognitive impairment, PIB-PET had higher sensitivity than FDG-PET for intermediate-high ADNC, with similar specificity. When both modalities are congruent, sensitivity and specificity approach 100%, whereas mixed pathology should be considered when PIB and FDG are incongruent. ANN NEUROL 2021;89389-401.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Tiazoles / Encéfalo / Radiofármacos / Placa Amiloide / Fluorodesoxiglucosa F18 / Tomografía de Emisión de Positrones / Demencia Frontotemporal / Enfermedad de Alzheimer / Compuestos de Anilina Tipo de estudio: Diagnostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Neurol Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Tiazoles / Encéfalo / Radiofármacos / Placa Amiloide / Fluorodesoxiglucosa F18 / Tomografía de Emisión de Positrones / Demencia Frontotemporal / Enfermedad de Alzheimer / Compuestos de Anilina Tipo de estudio: Diagnostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Neurol Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos