Using florbetapir positron emission tomography to explore cerebrospinal fluid cut points and gray zones in small sample sizes

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. © 2015 The Authors.

Paterson, R. W. (author)
Modat, M. (author)
Burgos, N. (author)
Cardoso, M. J. (author)
Magdalinou, N. (author)
Lehmann, M. (author)
Dickson, J. C. (author)
Barnes, A. (author)
Bomanji, J. B. (author)
Kayani, I. (author)
Cash, D. M. (author)
Ourselin, S. (author)
Toombs, J. (author)
Lunn, M. P. (author)
Mummery, C. J. (author)
Warren, J. D. (author)
Rossor, M. N. (author)
Fox, N. C. (author)
Zetterberg, Henrik,1973Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry(Swepub:gu)xzethe (author)
Schott, J. M. (author)
Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi (creator_code:org_t)

In:Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring: Wiley1:4, s. 440-4462352-8729

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Neurosciences

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