1. Head-to-Head Comparison of Tau and Amyloid Positron Emission Tomography Visual Reads for Differential Diagnosis of Neurodegenerative Disorders: An International, Multicenter Study.
- Author
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Soleimani-Meigooni DN, Smith R, Provost K, Lesman-Segev OH, Allen IE, Chen MK, Cho H, Edwards L, Janelidze S, La Joie R, Mundada N, Ossenkoppele R, Stomrud E, Strandberg O, Strom A, Boxer AL, Dage JL, Gorno-Tempini ML, Kramer JH, Miller BL, Rojas JC, Rosen HJ, Lyoo CH, Hansson O, and Rabinovici GD
- Subjects
- Humans, Female, Male, Aged, Diagnosis, Differential, Middle Aged, Carbolines, Neurodegenerative Diseases diagnostic imaging, Neurodegenerative Diseases diagnosis, Amyloid beta-Peptides metabolism, Biomarkers blood, Aged, 80 and over, Positron-Emission Tomography methods, tau Proteins cerebrospinal fluid, Cognitive Dysfunction diagnostic imaging, Cognitive Dysfunction diagnosis, Alzheimer Disease diagnostic imaging, Alzheimer Disease diagnosis, Alzheimer Disease metabolism
- Abstract
Objective: We compared the accuracy of amyloid and [
18 F]Flortaucipir (FTP) tau positron emission tomography (PET) visual reads for distinguishing patients with mild cognitive impairment (MCI) or dementia with fluid biomarker support of Alzheimer's disease (AD)., Methods: Participants with FTP-PET, amyloid-PET, and diagnosis of dementia-AD (n = 102), MCI-AD (n = 41), non-AD diseases (n = 76), and controls (n = 20) were included. AD status was determined independent of PET by cerebrospinal fluid or plasma biomarkers. The mean age was 66.9 years, and 44.8% were women. Three readers interpreted scans blindly and independently. Amyloid-PET was classified as positive/negative using tracer-specific criteria. FTP-PET was classified as positive with medial temporal lobe (MTL) binding as the minimum uptake indicating AD tau (tau-MTL+), positive with posterolateral temporal or extratemporal cortical binding in an AD-like pattern (tau-CTX+), or negative. The majority of scan interpretations were used to calculate diagnostic accuracy of visual reads in detecting MCI/dementia with fluid biomarker support for AD (MCI/dementia-AD)., Results: Sensitivity of amyloid-PET for MCI/dementia-AD was 95.8% (95% confidence interval 91.1-98.4%), which was comparable to tau-CTX+ 92.3% (86.7-96.1%, p = 0.67) and tau-MTL+ 97.2% (93.0-99.2%, p = 0.27). Specificity of amyloid-PET for biomarker-negative healthy and disease controls was 84.4% (75.5-91.0%), which was like tau-CTX+ 88.5% (80.4-94.1%, p = 0.34), and trended toward being higher than tau-MTL+ 75.0% (65.1-83.3%, p = 0.08). Tau-CTX+ had higher specificity than tau-MTL+ (p = 0.0002), but sensitivity was lower (p = 0.02), driven by decreased sensitivity for MCI-AD (80.5% [65.1-91.2] vs. 95.1% [83.5-99.4], p = 0.03)., Interpretation: Amyloid- and tau-PET visual reads have similar sensitivity/specificity for detecting AD in cognitively impaired patients. Visual tau-PET interpretations requiring cortical binding outside MTL increase specificity, but lower sensitivity for MCI-AD. ANN NEUROL 2024;96:476-487., (© 2024 American Neurological Association.)- Published
- 2024
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