Molecular imaging in the diagnosis of Alzheimer's disease: visual assessment of [11C]PIB and [18F]FDDNP PET images. Issue 8 (11th June 2010)

• Record Type: Journal Article
• Authors: Tolboom, Nelleke; van der Flier, Wiesje M; Boverhoff, Jolanda; Yaqub, Maqsood; Wattjes, Mike P; Raijmakers, Pieter G; Barkhof, Frederik; Scheltens, Philip; Herholz, Karl; Lammertsma, Adriaan A; van Berckel, Bart N M
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 81:Issue 8(2010)
• Page Start: 882
• Page End: 884
• Publication Date: 2010-06-11
• Subjects: Alzheimer's disease -- PET, ligand studies; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2009.194779
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: To evaluate visual assessment of [ 11 C]PIB and [ 18 F]FDDNP PET images as potential supportive diagnostic markers for Alzheimer's disease (AD). Methods: Twenty-one AD patients and 20 controls were included. Parametric [ 11 C]PIB and [ 18 F]FDDNP global binding potential (BPND ) images were visually rated as 'AD' or 'normal.' Data were compared with ratings of [ 18 F]FDG PET images and MRI-derived medial temporal lobe atrophy (MTA) scores. Inter-rater agreement and agreement with clinical diagnosis were assessed for all imaging modalities. In addition, cut-off values for quantitative global [ 11 C]PIB and [ 18 F]FDDNP BPND were determined. Visual ratings were compared with dichotomised quantitative values. Results: Agreement between readers was excellent for [ 11 C]PIB, [ 18 F]FDDNP and MTA (Cohen kappa κ≥0.85) and moderate for [ 18 F]FDG (κ=0.56). The highest sensitivity was found for [ 11 C]PIB and [ 18 F]FDG (both 1.0). The highest specificity was found for MTA (0.90) and [ 11 C]PIB (0.85). [ 18 F]FDDNP had the lowest sensitivity and specificity (0.67 and 0.53, respectively). The cut-off for quantitative [ 11 C]PIB BPND was 0.54 (sensitivity and specificity both 0.95) and for [ 18 F]FDDNP BPND 0.07 (sensitivity 0.80, specificity 0.73). Agreement between quantitative analyses and visual ratings was excellent for [ 11 C]PIB (κ=0.85) and fair for [ 18 F]FDDNP (κ=0.40). Conclusion: Visual assessment of [ 11 C]PIB images was straightforward and accurate, showing promise as a supportive diagnostic marker for AD. Moreover, [ 11 C]PIB showed the best combination of sensitivity and specificity. Visual assessment of [ 18 F]FDDNP images was insufficient. The quantitative analysis of [ 18 F]FDDNP data showed a considerably higher diagnostic value than the visual analysis.