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Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer’s disease

by Moretti Davide , Tarallo, Anna , Altomare Daniele , Tinazzi Michele , Garibotto Valentina , Cavaliere, Carlo , Morbelli, Silvia D , Bacchin Ruggero , Dottorini, Massimo E , Boccardi Marina , Dodich Alessandra , Savelli Giordano , Parapini Maura , Costa, Alfredo , Bauckneht Matteo , Mendes Aline , Salvatore, Marco , Assal Frederic , Ramusino Matteo Cotta , Farotti Lucia , Nobili Flavio , Salvatore, Elena , Salvadori, Nicola , Tranfaglia Cristina , Picco Agnese , Frisoni, Giovanni B

in Algorithms / Alzheimer's disease / Biomarkers / Cerebrospinal fluid / Cognitive ability / Dementia / Dementia disorders / Diagnosis / Diagnostic systems / Etiology / Magnetic resonance imaging / Medical diagnosis / Positron emission tomography / Tau protein

2020

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Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer’s disease

2020

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Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer’s disease

2020

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Journal Article

Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer’s disease

Moretti Davide,

Tarallo, Anna,

Altomare Daniele,

Tinazzi Michele,

Garibotto Valentina,

Cavaliere, Carlo,

Morbelli, Silvia D,

Bacchin Ruggero,

Dottorini, Massimo E,

Boccardi Marina,

Dodich Alessandra,

Savelli Giordano,

Parapini Maura,

Costa, Alfredo,

Bauckneht Matteo,

Mendes Aline,

Salvatore, Marco,

Assal Frederic,

Ramusino Matteo Cotta,

Farotti Lucia,

Nobili Flavio,

Salvatore, Elena,

Salvadori, Nicola,

Tranfaglia Cristina,

Picco Agnese,

Frisoni, Giovanni B

2020

Overview

PurposeTo compare the incremental diagnostic value of amyloid-PET and CSF (Aβ42, tau, and phospho-tau) in AD diagnosis in patients with mild cognitive impairment (MCI) or mild dementia, in order to improve the definition of diagnostic algorithm.MethodsTwo independent dementia experts provided etiological diagnosis and relative diagnostic confidence in 71 patients on 3 rounds, based on (1) clinical, neuropsychological, and structural MRI information alone; (2) adding one biomarker (CSF amyloid and tau levels or amyloid-PET with a balanced randomized design); and (3) adding the other biomarker.ResultsAmong patients with a pre-biomarker diagnosis of AD, negative PET induced significantly more diagnostic changes than amyloid-negative CSF at both rounds 2 (CSF 67%, PET 100%, P = 0.028) and 3 (CSF 0%; PET 78%, P < 0.001); PET induced a diagnostic confidence increase significantly higher than CSF on both rounds 2 and 3.ConclusionsAmyloid-PET should be prioritized over CSF biomarkers in the diagnostic workup of patients investigated for suspected AD, as it provides greater changes in diagnosis and diagnostic confidence.Trial registrationEudraCT no.: 2014-005389-31

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Publisher

Springer Nature B.V

Subject

Algorithms

/ Alzheimer's disease

/ Biomarkers

/ Cerebrospinal fluid

/ Cognitive ability

/ Dementia

/ Dementia disorders