Improved Risk Stratification for Progression from Mild Cognitive Impairment to Alzheimer's Disease with a Multi-Analytical Evaluation of Amyloid-β Positron Emission Tomography.

Beyer, Leonie; Brendel, Matthias; Scheiwein, Franziska; Sauerbeck, Julia; Hosakawa, Chisa; Alberts, Ian; Shi, Kuangyu; Bartenstein, Peter; Ishii, Kazunari; Seibyl, John; Cumming, Paul; Rominger, Axel (2020). Improved Risk Stratification for Progression from Mild Cognitive Impairment to Alzheimer's Disease with a Multi-Analytical Evaluation of Amyloid-β Positron Emission Tomography. Journal of Alzheimer's disease, 74(1), pp. 101-112. IOS Press 10.3233/JAD-190818

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BACKGROUND

Amyloid-β (Aβ) accumulation in brain of patients with suspected Alzheimer's disease (AD) can be assessed by positron emission tomography (PET) in vivo. While visual classification prevails in the clinical routine, semiquantitative PET analyses may enable more reliable evaluation of cases with a visually uncertain, borderline Aβ accumulation.

OBJECTIVE

We evaluated different analysis approaches (visual/semiquantitative) to find the most accurate and sensitive interpretation of Aβ-PET for predicting risk of progression from mild cognitive impairment (MCI) to AD.

METHODS

Based on standard uptake value (SUV) ratios of a cortical-composite volume of interest of 18F-AV45-PET from MCI subjects (n = 396, ADNI database), we compared three different reference region (cerebellar grey matter, CBL; brainstem, BST; white matter, WM) normalizations and the visual read by receiver operator characteristics for calculating a hazard ratio (HR) for progression to Alzheimer's disease dementia (ADD).

RESULTS

During a mean follow-up time of 45.6±13.0 months, 28% of the MCI cases (110/396) converted to ADD. Among the tested methods, the WM reference showed best discriminatory power and progression-risk stratification (HRWM of 4.4 [2.6-7.6]), but the combined results of the visual and semiquantitative analysis with all three reference regions showed an even higher discriminatory power.

CONCLUSION

A multi-analytical composite of visual and semiquantitative reference tissue analyses of 18F-AV45-PET gave improved risk stratification for progression from MCI to ADD relative to performance of single read-outs. This optimized approach is of special interest for prospective treatment trials, which demand a high accuracy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine

UniBE Contributor:

Alberts, Ian Leigh; Shi, Kuangyu; Cumming, Paul and Rominger, Axel Oliver

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1387-2877

Publisher:

IOS Press

Language:

English

Submitter:

Sabine Lanz

Date Deposited:

05 Jan 2021 17:13

Last Modified:

05 Jan 2021 17:13

Publisher DOI:

10.3233/JAD-190818

PubMed ID:

31985461

Uncontrolled Keywords:

Alzheimer’s disease amyloid-β biomarkers dementia mild cognitive impairment positron emission tomography

BORIS DOI:

10.48350/149137

URI:

https://boris.unibe.ch/id/eprint/149137

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