Diagnostic effectiveness of quantitative [¹⁸F]flutemetamol PET imaging for detection of fibrillar amyloid β using cortical biopsy histopathology as the standard of truth in subjects with idiopathic normal pressure hydrocephalus.
Diagnostic effectiveness of quantitative [¹⁸F]flutemetamol PET imaging for detection of fibrillar amyloid β using cortical biopsy histopathology as the standard of truth in subjects with idiopathic normal pressure hydrocephalus.
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DOI：
10.1186/2051-5960-2-46
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发表时间：
2014-04-22
影响因子：
7.1
通讯作者：
Grachev ID
中科院分区：
文献类型：
--
作者：
Leinonen V;Rinne JO;Wong DF;Wolk DA;Trojanowski JQ;Sherwin PF;Smith A;Heurling K;Su M;Grachev ID
体内淀粉样蛋白β (Aβ)的PET成像有望帮助阿尔茨海默病（AD）和轻度认知障碍的早期诊断和干预。ad样a β病理是特发性常压脑积水（iNPH）患者的常见合并症。50例需要脑室-腹膜分流术或颅内压监测的iNPH患者在手术前（N = 28）或手术后（N = 22）行氟替他莫PET [18F]。通过盲法评估[18F]氟替他莫的皮质摄取，并通过标准摄取值比（SUVR）定量评估与小脑或脑桥参考区域相关的特定新皮质区域：活检部位的（前瞻性研究）或周围（回顾性研究）的大脑皮质、对侧同质物和计算的复合脑测量。采用Bielschowsky银和硫黄素S斑块评分、Aβ单克隆抗体阳性灰质面积百分比（4G8）和总体病理印象来测量活检标本中的Aβ病理学（真实标准[SoT]）。我们打算找出(1)哪对PET SUVR和病理SoT终点匹配最好，(2)[18F]氟替他莫PET的定量测量是否比盲法图像检查（BIE）更能预测病理结果，以及(3)回顾性研究和前瞻性研究中PET图像结果之间是否有更好的匹配。在24种可能的终点/SoT组合中，基于整体病理的小脑SUVR和SoT组合的约登指数（1.000）最高，曲线下受者工作特征面积（1.000），敏感性（1.000），特异性（1.000），敏感性和特异性之和在汇总数据以及回顾性和前瞻性研究中分别为最高（2.00，所有3项）。使用Bielschowsky银作为SoT对所有suv（同侧，对侧和复合，两个参考区域）的BIE敏感性和特异性总和与定量相当。综合SUVR对整体病理诊断具有100%阳性预测值（两个参考区域）。所有越野车对贝尔肖夫斯基银的预测结果都是100%阴性。Bielschowsky银染色和整体病理判断显示与影像学结果的相关性最强。
PET imaging of amyloid-β (Aβ) in vivo holds promise for aiding in earlier diagnosis and intervention in Alzheimer’s disease (AD) and mild cognitive impairment. AD-like Aβ pathology is a common comorbidity in patients with idiopathic normal pressure hydrocephalus (iNPH). Fifty patients with iNPH needing ventriculo-peritoneal shunting or intracranial pressure monitoring underwent [18F]flutemetamol PET before (N = 28) or after (N = 22) surgery. Cortical uptake of [18F]flutemetamol was assessed visually by blinded reviewers, and also quantitatively via standard uptake value ratio (SUVR) in specific neocortical regions in relation to either cerebellum or pons reference region: the cerebral cortex of (prospective studies) or surrounding (retrospective studies) the biopsy site, the contralateral homolog, and a calculated composite brain measure. Aβ pathology in the biopsy specimen (standard of truth [SoT]) was measured using Bielschowsky silver and thioflavin S plaque scores, percentage area of grey matter positive for monoclonal antibody to Aβ (4G8), and overall pathology impression. We set out to find (1) which pair(s) of PET SUVR and pathology SoT endpoints matched best, (2) whether quantitative measures of [18F]flutemetamol PET were better for predicting the pathology outcome than blinded image examination (BIE), and (3) whether there was a better match between PET image findings in retrospective vs. prospective studies. Of the 24 possible endpoint/SoT combinations, the one with composite-cerebellum SUVR and SoT based on overall pathology had the highest Youden index (1.000), receiver operating characteristic area under the curve (1.000), sensitivity (1.000), specificity (1.000), and sum of sensitivity and specificity for the pooled data as well as for the retrospective and prospective studies separately (2.00, for all 3). The BIE sum of sensitivity and specificity, comparable to that for quantitation, was highest using Bielschowsky silver as SoT for all SUVRs (ipsilateral, contralateral, and composite, for both reference regions). The composite SUVR had a 100% positive predictive value (both reference regions) for the overall pathology diagnosis. All SUVRs had a 100% negative predictive value for the Bielschowsky silver result. Bielschowsky silver stain and overall pathology judgment showed the strongest associations with imaging results.
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影响因子：
12.7
作者：
Braak, Heiko;Del Tredici, Kelly
通讯作者：
Del Tredici, Kelly
影响因子：
11
作者：
Golomb, J;Wisoff, J;Graves, W
通讯作者：
Graves, W
影响因子：
4.8
作者：
Koivisto, Anne M.;Alafuzoff, Irina;Leinonen, Ville
通讯作者：
Leinonen, Ville
影响因子：
5.1
作者：
Leinonen, V.;Rinne, J. O.;Grachev, I. D.
通讯作者：
Grachev, I. D.
影响因子：
11.2
作者：
Hamilton, Roy;Patel, Sunil;Lee, Edward B.;Jackson, Eric M.;Lopinto, Joanna;Arnold, Steven E.;Clark, Christopher M.;Basil, Anuj;Shaw, Leslie M.;Xie, Sharon X.;Grady, M. Sean;Trojanowski, John Q.
通讯作者：
Trojanowski, John Q.