A systematic review and meta‐analysis of ¹⁸F‐labeled amyloid imaging in Alzheimer's disease

Abstract

BackgroundAmyloid imaging using fluorine 18–labeled tracers florbetapir, florbetaben, and flutemetamol has recently been reported in Alzheimer's disease (AD).MethodsWe systematically searched MEDLINE and EMBASE for relevant studies published from January 1980 to March 2014. Studies comparing imaging findings in AD and normal controls (NCs) were pooled in a meta-analysis, calculating pooled weighted sensitivity, specificity, and diagnostic odds ratio (OR) using the DerSimonian-Laird random-effects model.ResultsNineteen studies, investigating 682 patients with AD, met inclusion criteria. Meta-analysis demonstrated a sensitivity of 89.6%, a specificity of 87.2%, and an OR of 91.7 for florbetapir in differentiating AD patients from NCs, and a sensitivity of 89.3%, a specificity of 87.6%, and a diagnostic OR of 69.9 for florbetaben. There were insufficient data to complete analyses for flutemetamol.ConclusionsResults suggest favorable sensitivity and specificity of amyloid imaging with fluorine 18–labeled tracers in AD. Prospective studies are required to determine optimal imaging analysis methods and resolve outstanding clinical uncertainties.

18F‐Florbetaben PET/CT to Assess Alzheimer's Disease: A new Analysis Method for Regional Amyloid Quantification

“…Amyloid PET qualitative evaluation by using a systematic methodology specifically developed for this amyloid PET radiotracer that relies solely on the image visualization showed high accuracy in the classification of positive versus negative exams. 29 In our hands, the ROC analysis provided excellent results for the identification of the TP and the TN for amyloid PET compared to FDG PET, CDR > .5, CSF Tau, and p-Tau when applying the standard threshold of positivity. By increasing this threshold for Aβ-42 (<750 ng/mL) and considering the variability of this value within the different physiological and pathophysiological condition as suggested in other works, 23,24 we noticed an important increase of the performances of our assessments.…”

“…Amyloid PET qualitative evaluation by using a systematic methodology specifically developed for this amyloid PET radiotracer that relies solely on the image visualization showed high accuracy in the classification of positive versus negative exams . In our hands, the ROC analysis provided excellent results for the identification of the TP and the TN for amyloid PET compared to FDG PET, CDR > .5, CSF Tau, and p‐Tau when applying the standard threshold of positivity.…”

Applications of amyloid, tau, and neuroinflammation PET imaging to Alzheimer's disease and mild cognitive impairment

“…Noted strengths of [ 11 C]PiB include high amyloid selectivity and affinity, but technical limitations hinder its clinical use in centres without in-house cyclotrons such as its short decay half-life (Yeo, Waddell, Khan, & Pal, 2015). Additionally, there are significant operational costs associated with the construction and maintenance of a cyclotron on-site (Chuck et al, 2005).…”

Extremely Low Prevalence of Amyloid Positron Emission Tomography Positivity in Parkinson's Disease without Dementia

“…Most studies have determined Aβ positivity in persons without dementia using PIB PET [28]. A meta-analysis demonstrated a sensitivity of 89.3% and a specificity of 87.6% for FBB in differentiating AD patients from normal controls, indicating comparability of FBB to PIB tracer [38]. Neuropathological analyses have showed that FBB PET shows high sensitivity (97.9%) and specificity (88.9%) for detecting histopathology-confirmed neuritic Aβ plaques [39].…”