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

Matteo Cotta Ramusino, Valentina Garibotto, Ruggero Bacchin, Daniele Altomare, Alessandra Dodich, Frederic Assal, Aline Mendes, Alfredo Costa, Michele Tinazzi, Silvia D Morbelli, Matteo Bauckneht, Agnese Picco, Massimo E Dottorini, Cristina Tranfaglia, Lucia Farotti, Nicola Salvadori, Davide Moretti, Giordano Savelli, Anna Tarallo, Flavio Nobili & 6 others Maura Parapini, Carlo Cavaliere, Elena Salvatore, Marco Salvatore, Marina Boccardi, Giovanni B Frisoni

Research output: Contribution to journalArticle

Abstract

PURPOSE: To 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.

METHODS: Two 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.

RESULTS: Among 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.

CONCLUSIONS: Amyloid-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 REGISTRATION: EudraCT no.: 2014-005389-31.

Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
DOIs
Publication statusE-pub ahead of print - Aug 6 2019

Fingerprint

Amyloid
Alzheimer Disease
Biomarkers
Dementia
Granulocyte-Macrophage Colony-Stimulating Factor

Cite this

Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer's disease. / Ramusino, Matteo Cotta; Garibotto, Valentina; Bacchin, Ruggero; Altomare, Daniele; Dodich, Alessandra; Assal, Frederic; Mendes, Aline; Costa, Alfredo; Tinazzi, Michele; Morbelli, Silvia D; Bauckneht, Matteo; Picco, Agnese; Dottorini, Massimo E; Tranfaglia, Cristina; Farotti, Lucia; Salvadori, Nicola; Moretti, Davide; Savelli, Giordano; Tarallo, Anna; Nobili, Flavio; Parapini, Maura; Cavaliere, Carlo; Salvatore, Elena; Salvatore, Marco; Boccardi, Marina; Frisoni, Giovanni B.

In: European Journal of Nuclear Medicine and Molecular Imaging, 06.08.2019.

Research output: Contribution to journalArticle

Ramusino, MC, Garibotto, V, Bacchin, R, Altomare, D, Dodich, A, Assal, F, Mendes, A, Costa, A, Tinazzi, M, Morbelli, SD, Bauckneht, M, Picco, A, Dottorini, ME, Tranfaglia, C, Farotti, L, Salvadori, N, Moretti, D, Savelli, G, Tarallo, A, Nobili, F, Parapini, M, Cavaliere, C, Salvatore, E, Salvatore, M, Boccardi, M & Frisoni, GB 2019, 'Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer's disease', European Journal of Nuclear Medicine and Molecular Imaging. https://doi.org/10.1007/s00259-019-04466-6
Ramusino, Matteo Cotta ; Garibotto, Valentina ; Bacchin, Ruggero ; Altomare, Daniele ; Dodich, Alessandra ; Assal, Frederic ; Mendes, Aline ; Costa, Alfredo ; Tinazzi, Michele ; Morbelli, Silvia D ; Bauckneht, Matteo ; Picco, Agnese ; Dottorini, Massimo E ; Tranfaglia, Cristina ; Farotti, Lucia ; Salvadori, Nicola ; Moretti, Davide ; Savelli, Giordano ; Tarallo, Anna ; Nobili, Flavio ; Parapini, Maura ; Cavaliere, Carlo ; Salvatore, Elena ; Salvatore, Marco ; Boccardi, Marina ; Frisoni, Giovanni B. / Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer's disease. In: European Journal of Nuclear Medicine and Molecular Imaging. 2019.
@article{95ddfa84db0e4e479fd774a111a36fa6,
title = "Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer's disease",
abstract = "PURPOSE: To 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.METHODS: Two 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.RESULTS: Among 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.CONCLUSIONS: Amyloid-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 REGISTRATION: EudraCT no.: 2014-005389-31.",
author = "Ramusino, {Matteo Cotta} and Valentina Garibotto and Ruggero Bacchin and Daniele Altomare and Alessandra Dodich and Frederic Assal and Aline Mendes and Alfredo Costa and Michele Tinazzi and Morbelli, {Silvia D} and Matteo Bauckneht and Agnese Picco and Dottorini, {Massimo E} and Cristina Tranfaglia and Lucia Farotti and Nicola Salvadori and Davide Moretti and Giordano Savelli and Anna Tarallo and Flavio Nobili and Maura Parapini and Carlo Cavaliere and Elena Salvatore and Marco Salvatore and Marina Boccardi and Frisoni, {Giovanni B}",
year = "2019",
month = "8",
day = "6",
doi = "10.1007/s00259-019-04466-6",
language = "English",
journal = "European Journal of Nuclear Medicine and Molecular Imaging",
issn = "1619-7070",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer's disease

AU - Ramusino, Matteo Cotta

AU - Garibotto, Valentina

AU - Bacchin, Ruggero

AU - Altomare, Daniele

AU - Dodich, Alessandra

AU - Assal, Frederic

AU - Mendes, Aline

AU - Costa, Alfredo

AU - Tinazzi, Michele

AU - Morbelli, Silvia D

AU - Bauckneht, Matteo

AU - Picco, Agnese

AU - Dottorini, Massimo E

AU - Tranfaglia, Cristina

AU - Farotti, Lucia

AU - Salvadori, Nicola

AU - Moretti, Davide

AU - Savelli, Giordano

AU - Tarallo, Anna

AU - Nobili, Flavio

AU - Parapini, Maura

AU - Cavaliere, Carlo

AU - Salvatore, Elena

AU - Salvatore, Marco

AU - Boccardi, Marina

AU - Frisoni, Giovanni B

PY - 2019/8/6

Y1 - 2019/8/6

N2 - PURPOSE: To 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.METHODS: Two 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.RESULTS: Among 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.CONCLUSIONS: Amyloid-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 REGISTRATION: EudraCT no.: 2014-005389-31.

AB - PURPOSE: To 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.METHODS: Two 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.RESULTS: Among 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.CONCLUSIONS: Amyloid-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 REGISTRATION: EudraCT no.: 2014-005389-31.

U2 - 10.1007/s00259-019-04466-6

DO - 10.1007/s00259-019-04466-6

M3 - Article

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

SN - 1619-7070

ER -