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Comparing F-18-AV-1451 with CSF t-tau and p-tau for diagnosis of Alzheimer disease

Mattsson, N; Smith, R; Strandberg, O; Palmqvist, S; Scholl, M; Insel, PS; Hagerstrom, D; ... Hansson, O; + view all (2018) Comparing F-18-AV-1451 with CSF t-tau and p-tau for diagnosis of Alzheimer disease. Neurology , 90 (5) e388-e395. 10.1212/WNL.0000000000004887. Green open access

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Abstract

Objective: To compare PET imaging of tau pathology with CSF measurements (total tau [t-tau] and phosphorylated tau [p-tau]) in terms of diagnostic performance for Alzheimer disease (AD). Methods: We compared t-tau and p-tau and 18F-AV-1451 in 30 controls, 14 patients with prodromal AD, and 39 patients with Alzheimer dementia, recruited from the Swedish BioFINDER study. All patients with AD (prodromal and dementia) were screened for amyloid positivity using CSF β-amyloid 42. Retention of 18F-AV-1451 was measured in a priori specified regions, selected for known associations with tau pathology in AD. Results: Retention of 18F-AV-1451 was markedly elevated in Alzheimer dementia and moderately elevated in prodromal AD. CSF t-tau and p-tau was increased to similar levels in both AD dementia and prodromal AD. 18F-AV-1451 had very good diagnostic performance for Alzheimer dementia (area under the receiver operating characteristic curve [AUROC] ;1.000), and was significantly better than t-tau (0.876), p-tau (0.890), hippocampal volume (0.824), and temporal cortical thickness (0.860). For prodromal AD, there were no significant AUROC differences between CSF tau and 18F-AV-1451 measures (0.836–0.939), but MRI measures had lower AUROCs (0.652–0.769). Conclusions: CSF tau and 18F-AV-1451 have equal performance in early clinical stages of AD, but 18F-AV- 1451 is superior in the dementia stage, and exhibits close to perfect diagnostic performance for mild to moderate AD. Classification of evidence This study provides Class III evidence that CSF tau and 18F-AV-1451 PET have similar performance in identifying early AD, and that 18F-AV-1451 PET is superior to CSF tau in identifying mild to moderate AD.

Type: Article
Title: Comparing F-18-AV-1451 with CSF t-tau and p-tau for diagnosis of Alzheimer disease
Open access status: An open access version is available from UCL Discovery
DOI: 10.1212/WNL.0000000000004887
Publisher version: http://doi.org/10.1212/WNL.0000000000004887
Language: English
Additional information: Copyright © 2018 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10051813
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