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 - 2019/1/1
Y1 - 2019/1/1
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.
KW - Alzheimer’s disease
KW - Cerebrospinal fluid
KW - Incremental diagnostic value
KW - Mild cognitive impairment
KW - Positron emission tomography
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U2 - 10.1007/s00259-019-04466-6
DO - 10.1007/s00259-019-04466-6
M3 - Article
AN - SCOPUS:85070227959
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
ER -