Comparison of amyloid PET measured in Centiloid units with neuropathological findings in Alzheimer's disease
Comparison of amyloid PET measured in Centiloid units with neuropathological findings in Alzheimer's disease
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DOI：
10.1186/s13195-020-00587-5
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发表时间：
2020-03-04
影响因子：
9
通讯作者：
Rowe, Christopher C.
中科院分区：
文献类型：
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作者：
Amadoru, Sanka;Dore, Vincent;Rowe, Christopher C.
背景 Centiloid 量表的开发是为了标准化 β-淀粉样蛋白 (A beta) PET 的结果。我们的目的是确定 CERAD 稀疏和中等密度神经炎斑块的质心单位 (CL) 阈值、阿尔茨海默病 (AD) 中度或高概率的阿尔茨海默病神经病理改变 (ADNC) 评分、AD 的最终临床病理诊断以及阳性 Aβ PET 扫描的专家视觉读数。方法 将 49 名受试者的 CL 中的 A beta PET 结果与尸检结果、目视读取和最终临床病理诊断进行比较。 Youden 指数用于根据接受者操作特征 (ROC) 曲线确定最佳 CL 阈值。结果 20.1 CL 的阈值（校正死亡时间后为 21.3 CL，AUC 0.97）在检测中度或频繁斑块密度方面具有最高准确度，而 < 10 CL 是排除神经炎斑块的最佳值。 ADNC 中度或高可能性 AD 的阈值为 49.4 CL (AUC 0.98)。最终临床病理学诊断为 AD 的病例的中位 CL 结果为 87.7 (IQR +/- 42.2)，其中 94% > 45 CL。阳性视觉读数与 > 26 CL 的结果高度一致。结论 质心值 < 10 准确地反映了不存在任何神经炎斑块，> 20 CL 表明至少存在中等斑块密度，但大约 50 CL 或更高最能证实阿尔茨海默病的神经病理学和临床病理学诊断。
Background The Centiloid scale was developed to standardise the results of beta-amyloid (A beta) PET. We aimed to determine the Centiloid unit (CL) thresholds for CERAD sparse and moderate-density neuritic plaques, Alzheimer's disease neuropathologic change (ADNC) score of intermediate or high probability of Alzheimer's Disease (AD), final clinicopathological diagnosis of AD, and expert visual read of a positive A beta PET scan. Methods A beta PET results in CL for 49 subjects were compared with post-mortem findings, visual read, and final clinicopathological diagnosis. The Youden Index was used to determine the optimal CL thresholds from receiver operator characteristic (ROC) curves. Results A threshold of 20.1 CL (21.3 CL when corrected for time to death, AUC 0.97) yielded highest accuracy in detecting moderate or frequent plaque density while < 10 CL was optimal for excluding neuritic plaque. The threshold for ADNC intermediate or high likelihood AD was 49.4 CL (AUC 0.98). Those cases with a final clinicopathological diagnosis of AD yielded a median CL result of 87.7 (IQR +/- 42.2) with 94% > 45 CL. Positive visual read agreed highly with results > 26 CL. Conclusions Centiloid values < 10 accurately reflected the absence of any neuritic plaque and > 20 CL indicated the presence of at least moderate plaque density, but approximately 50 CL or more best confirmed both neuropathological and clinicopathological diagnosis of Alzheimer's disease.