TY - JOUR
T1 - Head-to-Head Comparison of Tau and Amyloid Positron Emission Tomography Visual Reads for Differential Diagnosis of Neurodegenerative Disorders
T2 - An International, Multicenter Study
AU - Soleimani-Meigooni, David N.
AU - Smith, Ruben
AU - Provost, Karine
AU - Lesman-Segev, Orit H.
AU - Allen, Isabel Elaine
AU - Chen, Miranda K.
AU - Cho, Hanna
AU - Edwards, Lauren
AU - Janelidze, Shorena
AU - La Joie, Renaud
AU - Mundada, Nidhi
AU - Ossenkoppele, Rik
AU - Stomrud, Erik
AU - Strandberg, Olof
AU - Strom, Amelia
AU - Boxer, Adam L.
AU - Dage, Jeffrey L.
AU - Gorno-Tempini, Maria Luisa
AU - Kramer, Joel H.
AU - Miller, Bruce L.
AU - Rojas, Julio C.
AU - Rosen, Howard J.
AU - Lyoo, Chul H.
AU - Hansson, Oskar
AU - Rabinovici, Gil D.
N1 - Publisher Copyright:
© 2024 American Neurological Association.
PY - 2024/9
Y1 - 2024/9
N2 - Objective: We compared the accuracy of amyloid and [18F]Flortaucipir (FTP) tau positron emission tomography (PET) visual reads for distinguishing patients with mild cognitive impairment (MCI) or dementia with fluid biomarker support of Alzheimer's disease (AD). Methods: Participants with FTP-PET, amyloid-PET, and diagnosis of dementia-AD (n = 102), MCI-AD (n = 41), non-AD diseases (n = 76), and controls (n = 20) were included. AD status was determined independent of PET by cerebrospinal fluid or plasma biomarkers. The mean age was 66.9 years, and 44.8% were women. Three readers interpreted scans blindly and independently. Amyloid-PET was classified as positive/negative using tracer-specific criteria. FTP-PET was classified as positive with medial temporal lobe (MTL) binding as the minimum uptake indicating AD tau (tau-MTL+), positive with posterolateral temporal or extratemporal cortical binding in an AD-like pattern (tau-CTX+), or negative. The majority of scan interpretations were used to calculate diagnostic accuracy of visual reads in detecting MCI/dementia with fluid biomarker support for AD (MCI/dementia-AD). Results: Sensitivity of amyloid-PET for MCI/dementia-AD was 95.8% (95% confidence interval 91.1–98.4%), which was comparable to tau-CTX+ 92.3% (86.7–96.1%, p = 0.67) and tau-MTL+ 97.2% (93.0–99.2%, p = 0.27). Specificity of amyloid-PET for biomarker-negative healthy and disease controls was 84.4% (75.5–91.0%), which was like tau-CTX+ 88.5% (80.4–94.1%, p = 0.34), and trended toward being higher than tau-MTL+ 75.0% (65.1–83.3%, p = 0.08). Tau-CTX+ had higher specificity than tau-MTL+ (p = 0.0002), but sensitivity was lower (p = 0.02), driven by decreased sensitivity for MCI-AD (80.5% [65.1–91.2] vs. 95.1% [83.5–99.4], p = 0.03). Interpretation: Amyloid- and tau-PET visual reads have similar sensitivity/specificity for detecting AD in cognitively impaired patients. Visual tau-PET interpretations requiring cortical binding outside MTL increase specificity, but lower sensitivity for MCI-AD. ANN NEUROL 2024;96:476–487.
AB - Objective: We compared the accuracy of amyloid and [18F]Flortaucipir (FTP) tau positron emission tomography (PET) visual reads for distinguishing patients with mild cognitive impairment (MCI) or dementia with fluid biomarker support of Alzheimer's disease (AD). Methods: Participants with FTP-PET, amyloid-PET, and diagnosis of dementia-AD (n = 102), MCI-AD (n = 41), non-AD diseases (n = 76), and controls (n = 20) were included. AD status was determined independent of PET by cerebrospinal fluid or plasma biomarkers. The mean age was 66.9 years, and 44.8% were women. Three readers interpreted scans blindly and independently. Amyloid-PET was classified as positive/negative using tracer-specific criteria. FTP-PET was classified as positive with medial temporal lobe (MTL) binding as the minimum uptake indicating AD tau (tau-MTL+), positive with posterolateral temporal or extratemporal cortical binding in an AD-like pattern (tau-CTX+), or negative. The majority of scan interpretations were used to calculate diagnostic accuracy of visual reads in detecting MCI/dementia with fluid biomarker support for AD (MCI/dementia-AD). Results: Sensitivity of amyloid-PET for MCI/dementia-AD was 95.8% (95% confidence interval 91.1–98.4%), which was comparable to tau-CTX+ 92.3% (86.7–96.1%, p = 0.67) and tau-MTL+ 97.2% (93.0–99.2%, p = 0.27). Specificity of amyloid-PET for biomarker-negative healthy and disease controls was 84.4% (75.5–91.0%), which was like tau-CTX+ 88.5% (80.4–94.1%, p = 0.34), and trended toward being higher than tau-MTL+ 75.0% (65.1–83.3%, p = 0.08). Tau-CTX+ had higher specificity than tau-MTL+ (p = 0.0002), but sensitivity was lower (p = 0.02), driven by decreased sensitivity for MCI-AD (80.5% [65.1–91.2] vs. 95.1% [83.5–99.4], p = 0.03). Interpretation: Amyloid- and tau-PET visual reads have similar sensitivity/specificity for detecting AD in cognitively impaired patients. Visual tau-PET interpretations requiring cortical binding outside MTL increase specificity, but lower sensitivity for MCI-AD. ANN NEUROL 2024;96:476–487.
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U2 - 10.1002/ana.27008
DO - 10.1002/ana.27008
M3 - Article
AN - SCOPUS:85196144225
SN - 0364-5134
VL - 96
SP - 476
EP - 487
JO - Annals of Neurology
JF - Annals of Neurology
IS - 3
ER -