One-Stop Shop: <sup>18</sup>F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases

Hammes, Jochen; Bischof, Gérard N.; Bohn, Karl Peter; Onur, Özgür; Schneider, Anja; Fließbach, Klaus; Hönig, Merle C.; Jessen, Frank; Neumaier, Bernd; Drzezga, Alexander; Eimeren, Thilo van

doi:10.2967/jnumed.120.244061

Cited by 23 publications

(19 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings were partially discordant with our expectation of a higher diagnostic value of tau-PET. Indeed, studies on tau-PET with 18F-Flortaucipir showed that (i) Braak stages, representing tau load and topography, better correlate with clinical symptoms than amyloid load [29,31,32]; (ii) its positivity indicates both advanced amyloid and tau neuropathology [23]; (iii) it proved to be able to differentiate between amyloidpositive and amyloid-negative neurodegenerative diseases with high accuracy [33]; (iv) tau deposition is closely related to other markers of neuronal injury, e.g., FDG-PET and gray matter atrophy [34][35][36]. On the other hand, amyloid-PET might be more sensitive than tau-PET to the early phases (amyloid is the first biomarker becoming abnormal during the AD course [37]), and, since it has been available for longer [4], it might be perceived by physicians as more reliable than tau-PET.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison

Altomare

Caprioglio

Assal

et al. 2021

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Purpose Assess the individual and combined diagnostic value of amyloid-PET and tau-PET in a memory clinic population. Methods Clinical reports of 136 patients were randomly assigned to two diagnostic pathways: AMY-TAU, amyloid-PET is presented before tau-PET; and TAU-AMY, tau-PET is presented before amyloid-PET. Two neurologists independently assessed all reports with a balanced randomized design, and expressed etiological diagnosis and diagnostic confidence (50–100%) three times: (i) at baseline based on the routine diagnostic workup, (ii) after the first exam (amyloid-PET for the AMY-TAU pathway, and tau-PET for the TAU-AMY pathway), and (iii) after the remaining exam. The main outcomes were changes in diagnosis (from AD to non-AD or vice versa) and in diagnostic confidence. Results Amyloid-PET and tau-PET, when presented as the first exam, resulted in a change of etiological diagnosis in 28% (p = 0.006) and 28% (p < 0.001) of cases, and diagnostic confidence increased by 18% (p < 0.001) and 19% (p < 0.001) respectively, with no differences between exams (p > 0.05). We observed a stronger impact of a negative amyloid-PET versus a negative tau-PET (p = 0.014). When added as the second exam, amyloid-PET and tau-PET resulted in a further change in etiological diagnosis in 6% (p = 0.077) and 9% (p = 0.149) of cases, and diagnostic confidence increased by 4% (p < 0.001) and 5% (p < 0.001) respectively, with no differences between exams (p > 0.05). Conclusion Amyloid-PET and tau-PET significantly impacted diagnosis and diagnostic confidence in a similar way, although a negative amyloid-PET has a stronger impact on diagnosis than a negative tau-PET. Adding either of the two as second exam further improved diagnostic confidence. Trial number PB 2016-01346.

show abstract

Section: Discussionmentioning

confidence: 99%

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison

Altomare

Caprioglio

Assal

et al. 2021

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

show abstract

“…As for tau-PET, both clinicians and biomarker experts appear to already rely on this exam in clinical practice. This might be due to its ability to differentiate between amyloid-positive and negative neurodegenerative diseases with high accuracy [11] and to the evidence that the accumulation of pathologic tau is closely related to functional and structural deterioration in the AD spectrum [24]. The relatively low additional value attributed to FDG-PET might be due its nature of nonspeci c measure of neurodegeneration, detecting damage that may derive not only from AD but from a variety of etiologies, for example cerebrovascular injury [2].…”

Section: Discussionmentioning

confidence: 99%

“…Among all these biomarkers, a major progress in the last years is the advent of amyloid-PET and tau-PET: this novel molecular imaging technique makes possible to visualize the topography of amyloid and tau deposits in the brain, previously measurable only indirectly via CSF. Speci cally, given the strong association between tau pathology and symptoms, already known from neuropathological studies, and given the relative speci city of tau-PET tracers for tau deposits in AD, tau-PET could represent the most e cient imaging modality in AD: a positive tau-PET might be an indicator of both amyloid and tau pathology and thus provide a de nite diagnostic answer with only one test [11,12]. However, this interpretation might depend on the relative role attributed by the interpreting physician and clinician to amyloid and tau pathology in the physiopathology of AD [13].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Use of Alzheimer’s Biomarkers in Patients With Mild Cognitive Impairment: A European Alzheimer’s Disease Consortium Survey

Caprioglio

Garibotto

Jessen

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Background. This study aims to investigate the clinical use of the main Alzheimer’s disease (AD) biomarkers in patients with mild cognitive impairment (MCI) by examining the beliefs and preferences of clinicians and biomarker experts of the European Alzheimer’s Disease Consortium (EADC).Methods. Out of 306 contacted EADC professionals, 150 (101 clinicians, 43 biomarker experts, and 6 falling into other categories) filled in an online survey from May to September 2020. The investigated biomarkers were: medial temporal lobe atrophy score (MTA) on structural MRI, typical AD (i.e. temporoparietal and posterior cingulate) hypometabolism on FDG-PET, CSF (Aβ42, p-tau, t-tau), amyloid-PET and tau-PET.Results. Despite the abnormal accumulation of amyloid rather than tau was deemed by the majority of responders as the initial cause of AD, responders did not show a clear preference for amyloid-PET. The most widely used biomarker is MTA (77% of responders reported to use it at least frequently), followed by Aβ42, p-tau, t-tau levels in CSF (45%), typical AD hypometabolism on FDG-PET (32%), amyloid-PET (8%), and tau-PET (2%). Imaging and CSF biomarkers were found to be widely used to support the etiological diagnostic process in MCI, while APOE genotyping was performed only in a minority of patients. CSF is considered the most valuable biomarker in terms of additional diagnostic value, followed by amyloid-PET, tau-PET, and typical AD hypometabolism on FDG-PET. The combination of amyloidosis and neuronal injury biomarkers is associated with the highest diagnostic confidence in an etiological diagnosis of AD in MCI, while MTA alone was perceived as the less reliable biomarker.Conclusions. Biomarkers are widely used across Europe for the diagnosis of MCI. Overall, we observed that CSF is currently considered as the most useful biomarker, followed by amyloid-PET. Moreover, the use of molecular imaging (i.e. amyloid-PET and tau-PET) in the diagnostic work-up of MCI patients is increasing over time.

show abstract

“…It does not detect earlier Braak stages reliably and does not bind strongly to tau isoforms in progressive supranuclear palsy and other non-AD tauopathies [ 46 ]. In spite of these reservations, it may have a potential for differentiation between AD and non-AD diseases similar to amyloid PET [ 47 , 48 ].…”

Section: Imaging Techniquesmentioning

confidence: 99%

Imaging Clinical Subtypes and Associated Brain Networks in Alzheimer’s Disease

Herholz

2022

Brain Sciences

View full text Add to dashboard Cite

Alzheimer’s disease (AD) does not present uniform symptoms or a uniform rate of progression in all cases. The classification of subtypes can be based on clinical symptoms or patterns of pathological brain alterations. Imaging techniques may allow for the identification of AD subtypes and their differentiation from other neurodegenerative diseases already at an early stage. In this review, the strengths and weaknesses of current clinical imaging methods are described. These include positron emission tomography (PET) to image cerebral glucose metabolism and pathological amyloid or tau deposits. Magnetic resonance imaging (MRI) is more widely available than PET. It provides information on structural or functional changes in brain networks and their relation to AD subtypes. Amyloid PET provides a very early marker of AD but does not distinguish between AD subtypes. Regional patterns of pathology related to AD subtypes are observed with tau and glucose PET, and eventually as atrophy patterns on MRI. Structural and functional network changes occur early in AD but have not yet provided diagnostic specificity.

show abstract

One-Stop Shop: ¹⁸F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases

Cited by 23 publications

References 43 publications

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison

The Clinical Use of Alzheimer’s Biomarkers in Patients With Mild Cognitive Impairment: A European Alzheimer’s Disease Consortium Survey

Imaging Clinical Subtypes and Associated Brain Networks in Alzheimer’s Disease

Contact Info

Product

Resources

About

One-Stop Shop: 18F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases

Cited by 23 publications

References 43 publications

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison

The Clinical Use of Alzheimer’s Biomarkers in Patients With Mild Cognitive Impairment: A European Alzheimer’s Disease Consortium Survey

Imaging Clinical Subtypes and Associated Brain Networks in Alzheimer’s Disease

Contact Info

Product

Resources

About

One-Stop Shop: ¹⁸F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases