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Publication Detail
Using florbetapir positron emission tomography to explore cerebrospinal fluid cut points and gray zones in small sample sizes
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Journal Article
  • Authors:
    Weston PSJ, Paterson RW, Modat M, Burgos N, Cardoso MJ, Magdalinou N, Lehmann M, Dickson JC, Barnes A, Bomanji JB, Kayani I, Cash DM, Ourselin S, Toombs J, Lunn MP, Mummery CJ, Warren JD, Rossor MN, Fox NC, Zetterberg H, Schott JM
  • Publication date:
    01/12/2015
  • Pagination:
    440, 446
  • Journal:
    Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
  • Volume:
    1
  • Issue:
    4
  • Status:
    Published
Abstract
© 2015 The Authors. 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/Aβ 1-42 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 Aβ 1-42 of 630 ng/L, and 20 of 20 on tau/Aβ 1-42 ratio (positive ≥0.88; negative ≤0.34). Three discordant cases had Aβ 1-42 levels between 403 and 729 ng/L and tau/Aβ 1-42 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/Aβ 1-42 ratio appears robust at predicting amyloid status, although there are gray zones where there remains diagnostic uncertainty.
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