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

Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
Philip S J WestonJonathan M Schott

Abstract

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). 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. 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. 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.

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Citations

Oct 22, 2016·Journal of Alzheimer's Disease : JAD·Philip S J WestonJonathan M Schott
Nov 21, 2017·Journal of Alzheimer's Disease : JAD·Ignacio ÁlvarezPau Pastor
Nov 13, 2018·Alzheimer's & Dementia : the Journal of the Alzheimer's Association·Zhicheng ChenDominic M Walsh
Jul 20, 2019·Alzheimer's Research & Therapy·Jurre den HaanKeir X X Yong
Feb 15, 2017·Alzheimer's Research & Therapy·Daniela BertensPieter Jelle Visser
Mar 17, 2020·Journal of Alzheimer's Disease : JAD·Gargi BanerjeeDavid J Werring
Aug 31, 2021·Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring·Lajos CsincsikImre Lengyel

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Methods Mentioned

BETA
enzyme-linked immunosorbent assays

Software Mentioned

STATA

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