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Using florbetapir positron emission tomography to explore cerebrospinal fluid cut points and gray zones in small sample sizes

Weston, PS; Paterson, RW; Modat, M; Burgos, N; Cardoso, MJ; Magdalinou, N; Lehmann, M; ... Schott, JM; + view all (2015) Using florbetapir positron emission tomography to explore cerebrospinal fluid cut points and gray zones in small sample sizes. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring , 1 (4) pp. 440-446. 10.1016/j.dadm.2015.10.001. Green open access

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Abstract

INTRODUCTION: We aimed to assess the feasibility of determining Alzheimer's disease cerebrospinal fluid (CSF) cut points in small samples through comparison with amyloid positron emission tomography (PET). METHODS: Twenty-three individuals (19 patients, four controls) had CSF measures of amyloid beta (Aβ)1-42 and total tau/Aβ1-42 ratio, and florbetapir PET. We compared CSF measures with visual and quantitative (standardized uptake value ratio [SUVR]) PET measures of amyloid. RESULTS: Seventeen of 23 were amyloid-positive on visual reads, and 14 of 23 at an SUVR of ≥1.1. There was concordance (positive/negative on both measures) in 20 of 23, of whom 19 of 20 were correctly classified at an Aβ1-42 of 630 ng/L, and 20 of 20 on tau/Aβ1-42 ratio (positive ≥0.88; negative ≤0.34). Three discordant cases had Aβ1-42 levels between 403 and 729 ng/L and tau/Aβ1-42 ratios of 0.54-0.58. DISCUSSION: Comparing amyloid PET and CSF biomarkers provides a means of assessing CSF cut points in vivo, and can be applied to small sample sizes. CSF tau/Aβ1-42 ratio appears robust at predicting amyloid status, although there are gray zones where there remains diagnostic uncertainty.

Type: Article
Title: Using florbetapir positron emission tomography to explore cerebrospinal fluid cut points and gray zones in small sample sizes
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.dadm.2015.10.001
Publisher version: http://dx.doi.org/10.1016/j.dadm.2015.10.001
Language: English
Additional information: © 2015 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Amyloid PET, Aβ, Cerebrospinal fluid, Cut points, Diagnosis, Phosphorylated tau, Tau
UCL classification: UCL > Office of the President and Provost
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology > Molecular Neuroscience
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology > Neurodegenerative Diseases
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > School of BEAMS
UCL > School of BEAMS > Faculty of Engineering Science
URI: http://discovery.ucl.ac.uk/id/eprint/1475097
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