Introducing a gatekeeping system for amyloid status assessment in mild cognitive impairment.

Autor: Doering E; German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany. elena.doering@uk-koeln.de.; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, Cologne, Germany. elena.doering@uk-koeln.de., Hoenig MC; German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.; Institute for Neuroscience and Medicine II-Molecular Organization of the Brain, Research Center Juelich, Jülich, Germany., Bischof GN; German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.; Institute for Neuroscience and Medicine II-Molecular Organization of the Brain, Research Center Juelich, Jülich, Germany., Bohn KP; Klinikum Dritter Orden, Department of Radiology and Nuclear Medicine, Munich, Germany., Ellingsen LM; Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA.; Department of Electrical and Computer Engineering, University of Iceland, Reykjavik, Iceland., van Eimeren T; German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany., Drzezga A; German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, Cologne, Germany.; Institute for Neuroscience and Medicine II-Molecular Organization of the Brain, Research Center Juelich, Jülich, Germany.
Jazyk: angličtina
Zdroj: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2022 Nov; Vol. 49 (13), pp. 4478-4489. Date of Electronic Publication: 2022 Jul 14.
DOI: 10.1007/s00259-022-05879-6
Abstrakt: Background: In patients with mild cognitive impairment (MCI), enhanced cerebral amyloid-β plaque burden is a high-risk factor to develop dementia with Alzheimer's disease (AD). Not all patients have immediate access to the assessment of amyloid status (A-status) via gold standard methods. It may therefore be of interest to find suitable biomarkers to preselect patients benefitting most from additional workup of the A-status. In this study, we propose a machine learning-based gatekeeping system for the prediction of A-status on the grounds of pre-existing information on APOE-genotype 18 F-FDG PET, age, and sex.
Methods: Three hundred and forty-two MCI patients were used to train different machine learning classifiers to predict A-status majority classes among APOE-ε4 non-carriers (APOE4-nc; majority class: amyloid negative (Aβ-)) and carriers (APOE4-c; majority class: amyloid positive (Aβ +)) from 18 F-FDG-PET, age, and sex. Classifiers were tested on two different datasets. Finally, frequencies of progression to dementia were compared between gold standard and predicted A-status.
Results: Aβ- in APOE4-nc and Aβ + in APOE4-c were predicted with a precision of 87% and a recall of 79% and 51%, respectively. Predicted A-status and gold standard A-status were at least equally indicative of risk of progression to dementia.
Conclusion: We developed an algorithm allowing approximation of A-status in MCI with good reliability using APOE-genotype, 18 F-FDG PET, age, and sex information. The algorithm could enable better estimation of individual risk for developing AD based on existing biomarker information, and support efficient selection of patients who would benefit most from further etiological clarification. Further potential utility in clinical routine and clinical trials is discussed.
(© 2022. The Author(s).)
Databáze: MEDLINE
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