Open AccessPerformance of [ 18 F]flutemetamol amyloid imaging against the neuritic plaque component of CERAD and the current (2012) NIA‐AA recommendations for the neuropathologic diagnosis of Alzheimer's disease
Author(s) -
Salloway Stephen,
Gamez Jose E.,
Singh Upinder,
Sadowsky Carl H.,
Villena Teresa,
Sabbagh Marwan N.,
Beach Thomas G.,
Duara Ranjan,
Fleisher Adam S.,
Frey Kirk A.,
Walker Zuzana,
Hunjan Arvinder,
Escovar Yavir M.,
Agronin Marc E.,
Ross Joel,
Bozoki Andrea,
Akinola Mary,
Shi Jiong,
Vandenberghe Rik,
Ikonomovic Milos D.,
Sherwin Paul F.,
Farrar Gill,
Smith Adrian P.L.,
Buckley Christopher J.,
Thal Dietmar Rudolf,
Zanette Michelle,
Curtis Craig
Publication year - 2017
Publication title -
alzheimer's and dementia: diagnosis, assessment and disease monitoring
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.497
H-Index - 37
ISSN - 2352-8729
DOI - 10.1016/j.dadm.2017.06.001
Subject(s) - positron emission tomography , senile plaques , medicine , amyloid (mycology) , pittsburgh compound b , pathology , alzheimer's disease , nuclear medicine , disease
Performance of the amyloid tracer [ 18 F]flutemetamol was evaluated against three pathology standard of truth (SoT) measures including neuritic plaques (CERAD “original” and “modified” and the amyloid component of the 2012 NIA‐AA guidelines). Methods After [ 18 F]flutemetamol imaging, 106 end‐of‐life patients who died underwent postmortem brain examination for amyloid plaque load. Blinded positron emission tomography scan interpretations by five independent electronically trained readers were compared with pathology measures. Results By SoT, sensitivity and specificity of majority image interpretations were, respectively, 91.9% and 87.5% with “original CERAD,” 90.8% and 90.0% with “modified CERAD,” and 85.7% and 100% with the 2012 NIA‐AA criteria. Discussion The high accuracy of either CERAD criteria suggests that [ 18 F]flutemetamol predominantly reflects neuritic amyloid plaque density. However, the use of CERAD criteria as the SoT can result in some false‐positive results because of the presence of diffuse plaques, which are accounted for when the positron emission tomography read is compared with the 2012 NIA‐AA criteria.