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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2020

01-02-2020 | Alzheimer's Disease | Original Article

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

Authors: 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, Maura Parapini, Carlo Cavaliere, Elena Salvatore, Marco Salvatore, Marina Boccardi, Giovanni B Frisoni

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2020

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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
Appendix
Available only for authorised users
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Metadata
Title
Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer’s disease
Authors
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
Maura Parapini
Carlo Cavaliere
Elena Salvatore
Marco Salvatore
Marina Boccardi
Giovanni B Frisoni
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04466-6

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