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.
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Using florbetapir positron emission tomography to explore cerebrospinal fluid cut points and gray zones in small sample sizes.pdf - Published Version Download (565kB) | Preview |
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.
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