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Article: Heterogeneity of amyloid binding in cognitively impaired patients consecutively recruited from a memory clinic: evaluating the utility of quantitative 18F-Flutemetamol PET-CT in discrimination of Mild Cognitive Impairment from Alzheimer’s disease and other Dementias

TitleHeterogeneity of amyloid binding in cognitively impaired patients consecutively recruited from a memory clinic: evaluating the utility of quantitative 18F-Flutemetamol PET-CT in discrimination of Mild Cognitive Impairment from Alzheimer’s disease and other Dementias
Authors
KeywordsAlzheimer’s disease
amyloid
dementia
early-onset Alzheimer’s disease
18F-Flutemetamol
Issue Date2021
PublisherIOS Press. The Journal's web site is located at http://www.iospress.nl/html/13872877.php
Citation
Journal of Alzheimer's Disease, 2021, v. 79 n. 2, p. 819-832 How to Cite?
AbstractBackground: With the more widespread use of 18F-radioligand-based amyloid-β (Aβ) PET-CT imaging, we evaluated Aβ binding and the utility of neocortical 18F-Flutemetamol standardized uptake value ratio (SUVR) as a biomarker. Objective: 18F-Flutemetamol SUVR was used to differentiate 1) mild cognitive impairment (MCI) from Alzheimer’s disease (AD), and 2) MCI from other non-AD dementias (OD). Methods: 109 patients consecutively recruited from a University memory clinic underwent clinical evaluation, neuropsychological test, MRI and 18F-Flutemetamol PET-CT. The diagnosis was made by consensus of a panel consisting of 1 neuroradiologist and 2 geriatricians. The final cohort included 13 subjective cognitive decline (SCD), 22 AD, 39 MCI, and 35 OD. Quantitative analysis of 16 region-of-interests made by Cortex ID software (GE Healthcare). Results: The global mean 18F-Flutemetamol SUVR in SCD, MCI, AD, and OD were 0.50 (SD-0.08), 0.53 (SD-0.16), 0.76 (SD-0.10), and 0.56 (SD-0.16), respectively, with SUVR in SCD and MCI and OD being significantly lower than AD. Aβ binding in SCD, MCI, and OD was heterogeneous, being 23%, 38.5%, and 42.9% respectively, as compared to 100% amyloid positivity in AD. Using global SUVR, ROC analysis showed AUC of 0.868 and 0.588 in differentiating MCI from AD and MCI from OD respectively. Conclusion: 18F-Flutemetamol SUVR differentiated MCI from AD with high efficacy (high negative predictive value), but much lower efficacy from OD. The major benefit of the test was to differentiate cognitively impaired patients (either SCD, MCI, or OD) without AD-related-amyloid-pathology from AD in the clinical setting, which was under-emphasized in the current guidelines proposed by Amyloid Imaging Task Force.
Persistent Identifierhttp://hdl.handle.net/10722/306377
ISSN
2023 Impact Factor: 3.4
2023 SCImago Journal Rankings: 1.172
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorBAO, Y-
dc.contributor.authorChau, A-
dc.contributor.authorChiu, PKC-
dc.contributor.authorShea, YF-
dc.contributor.authorKwan, JSK-
dc.contributor.authorChan, HWF-
dc.contributor.authorMak, HKF-
dc.date.accessioned2021-10-20T10:22:44Z-
dc.date.available2021-10-20T10:22:44Z-
dc.date.issued2021-
dc.identifier.citationJournal of Alzheimer's Disease, 2021, v. 79 n. 2, p. 819-832-
dc.identifier.issn1387-2877-
dc.identifier.urihttp://hdl.handle.net/10722/306377-
dc.description.abstractBackground: With the more widespread use of 18F-radioligand-based amyloid-β (Aβ) PET-CT imaging, we evaluated Aβ binding and the utility of neocortical 18F-Flutemetamol standardized uptake value ratio (SUVR) as a biomarker. Objective: 18F-Flutemetamol SUVR was used to differentiate 1) mild cognitive impairment (MCI) from Alzheimer’s disease (AD), and 2) MCI from other non-AD dementias (OD). Methods: 109 patients consecutively recruited from a University memory clinic underwent clinical evaluation, neuropsychological test, MRI and 18F-Flutemetamol PET-CT. The diagnosis was made by consensus of a panel consisting of 1 neuroradiologist and 2 geriatricians. The final cohort included 13 subjective cognitive decline (SCD), 22 AD, 39 MCI, and 35 OD. Quantitative analysis of 16 region-of-interests made by Cortex ID software (GE Healthcare). Results: The global mean 18F-Flutemetamol SUVR in SCD, MCI, AD, and OD were 0.50 (SD-0.08), 0.53 (SD-0.16), 0.76 (SD-0.10), and 0.56 (SD-0.16), respectively, with SUVR in SCD and MCI and OD being significantly lower than AD. Aβ binding in SCD, MCI, and OD was heterogeneous, being 23%, 38.5%, and 42.9% respectively, as compared to 100% amyloid positivity in AD. Using global SUVR, ROC analysis showed AUC of 0.868 and 0.588 in differentiating MCI from AD and MCI from OD respectively. Conclusion: 18F-Flutemetamol SUVR differentiated MCI from AD with high efficacy (high negative predictive value), but much lower efficacy from OD. The major benefit of the test was to differentiate cognitively impaired patients (either SCD, MCI, or OD) without AD-related-amyloid-pathology from AD in the clinical setting, which was under-emphasized in the current guidelines proposed by Amyloid Imaging Task Force.-
dc.languageeng-
dc.publisherIOS Press. The Journal's web site is located at http://www.iospress.nl/html/13872877.php-
dc.relation.ispartofJournal of Alzheimer's Disease-
dc.rightsThe final publication is available at IOS Press through https://doi.org/10.3233/JAD-200890-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAlzheimer’s disease-
dc.subjectamyloid-
dc.subjectdementia-
dc.subjectearly-onset Alzheimer’s disease-
dc.subject18F-Flutemetamol-
dc.titleHeterogeneity of amyloid binding in cognitively impaired patients consecutively recruited from a memory clinic: evaluating the utility of quantitative 18F-Flutemetamol PET-CT in discrimination of Mild Cognitive Impairment from Alzheimer’s disease and other Dementias-
dc.typeArticle-
dc.identifier.emailMak, HKF: makkf@hku.hk-
dc.identifier.authorityMak, HKF=rp00533-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3233/JAD-200890-
dc.identifier.pmid33361593-
dc.identifier.pmcidPMC7902948-
dc.identifier.scopuseid_2-s2.0-85100445485-
dc.identifier.hkuros326634-
dc.identifier.volume79-
dc.identifier.issue2-
dc.identifier.spage819-
dc.identifier.epage832-
dc.identifier.isiWOS:000611560100028-
dc.publisher.placeNetherlands-

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