Where Should I Draw the Line: PET-Driven, Data-Driven, or Manufacturer Cut-Off?
J Alzheimers Dis
; 98(3): 957-967, 2024.
Article
de En
| MEDLINE
| ID: mdl-38489172
ABSTRACT
Background:
The optimal cut-off for Alzheimer's disease (AD) CSF biomarkers remains controversial.Objective:
To analyze the performance of cut-off points standardized by threemethods:
one that optimized the agreement between 11C-Pittsburgh compound B PET (a-PET) and CSF biomarkers (Aß1-42, pTau, tTau, and Aß1-42/Aß1-40 ratio) in our population, called PET-driven; an unbiased cut-off using data from a healthy research cohort, called data-driven, and that provided by the manufacturer. We also compare changes in ATN classification.Methods:
CSF biomarkers measured by the LUMIPULSE G600II platform and qualitative visualization of amyloid positron emission tomography (a-PET) were performed in all the patients. We established a cut-off for each single biomarker and Aß1-42/Aß1-40 ratio that optimized their agreement with a-PET using ROC curves. Sensitivity, Specificity, and Overall Percent of Agreement are assessed using a-PET or clinical diagnosis as gold standard for every cut-off. Also, we established a data-driven cut-off from our cognitively unimpaired cohort. We then analyzed changes in ATN classification.Results:
One hundred and ten patients were recruited. Sixty-six (60%) were a-PET positive. PET-driven cut-offs were pTauâ>â57, tTauâ>â362.62, Aß1-42/Aß1-40â<â0.069. For a single biomarker, pTau showed the highest accuracy (AUC 0.926). New PET-driven cut-offs classified patients similarly to manufacturer cut-offs (only two patients changed). However, 20 patients (18%) changed when data-driven cut-offs were used.Conclusions:
We established our sample's best CSF biomarkers cut-offs using a-PET as the gold standard. These cut-offs categorize better symptomatic subjects than data-driven in ATN classification, but they are very similar to the manufacturer's.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Peptides bêta-amyloïdes
/
Maladie d'Alzheimer
Limites:
Humans
Langue:
En
Journal:
J Alzheimers Dis
/
J. alzheimers dis
/
Journal of alzheimer's disease
Sujet du journal:
GERIATRIA
/
NEUROLOGIA
Année:
2024
Type de document:
Article
Pays d'affiliation:
Espagne
Pays de publication:
Pays-Bas