| Autor: |
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. |
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| Zdroj: |
Annals of Neurology; Feb2021, Vol. 89 Issue 2, p389-401, 13p |
| Abstrakt: |
Objective: The purpose of this study was to compare the diagnostic accuracy of antemortem 11C‐Pittsburgh compound B (PIB) and 18F‐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;89:389–401 [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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