Abstract Details

Title Comparison of [18F]Flutemetamol PET Image Interpretation with Clinical Diagnosis of Alzheimer's Disease: Neuritic Plaque Density Standard Based on Consortium To Establish a Registry for Alzheimer's Disease Criteria

Topic Aging and Dementia

Presentation(s) S04 - (-)

Poster/Presentation
Number 007

Objective

Background Non-invasive methods to detect fibrillar amyloid b in vivo provide useful diagnostic information. Sensitivity, specificity, and reproducibility establish efficacy. PPV/NPV are the probability of the presence/absence of disease or pathology given a positive/negative test result.

Design/Methods 180 end-of-life subjects at 19 US and European centers received Flutemetamol F 18 Injection (370 MBq) i.v. and underwent 10-minute PET imaging. Images were interpreted by 5 trained readers blinded to subject information. Brain specimens from subjects who died were stained with Bielschowsky silver stain and read as normal or abnormal for neuritic plaque density using modified Consortium to Establish a Registry for Alzheimer's Disease (CERAD) scoring; results were used as the truth standard.

Results Of the 68 evaluable brains collected, 43 brains had abnormal and 25 brains had normal neuritic plaque density. By majority read of the PET images, 39 brains had elevated levels of fibrillar amyloid (abnormal) and 29 brains had levels below the detectable limit (normal). Agreement between the 5 readers was very good with a kappa of 0.79. Visual interpretation of PET images had sensitivity of 86%, specificity of 92%, PPV of 95%, and NPV of 79% Reported medical histories included AD for 30 subjects, other dementing disorder for 17 subjects, and no history of cognitive impairment for 21 subjects. Clinical diagnosis had sensitivity of 51%, specificity of 68%, PPV of 73%, and NPV of 45%.

Conclusions [18F]Flutemetamol PET image interpretation was more consistent with post mortem neuritic plaque density than clinical diagnosis of AD. A normal [18F]flutemetamol PET scan is inconsistent with the presence of brain fibrillar amyloid and pathological diagnosis of AD.

Authors/Disclosures
Stephen P. Salloway, MD, MS (Brown Medical School) PRESENTER	Dr. Salloway has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Salloway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EISAI. Dr. Salloway has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lilly. Dr. Salloway has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Salloway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for NovoNordisk. Dr. Salloway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Prothena. Dr. Salloway has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Salloway has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurophet. Dr. Salloway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Acumen. Dr. Salloway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Kisbee. Dr. Salloway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Salloway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CognitionRX. Dr. Salloway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Icometrix. Dr. Salloway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acumen. Dr. Salloway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck.
	No disclosure on file
	No disclosure on file
Carl H. Sadowsky, MD, FAAN	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Igor Grachev	No disclosure on file
	No disclosure on file
Marwan N. Sabbagh, MD, FAAN (Barrow Neurological Institute)	Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eisai. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genetech=Roche. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novo Nordisk. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Synaptogenix. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant Health. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Anavex. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cognito Therapeutics. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for CervoMed. Dr. Sabbagh has stock in Neurotau. Dr. Sabbagh has stock in Seq Biomarque. Dr. Sabbagh has stock in uMethod Health. Dr. Sabbagh has stock in Athira. Dr. Sabbagh has stock in Lighthouse Pharmaceuticals. Dr. Sabbagh has stock in Alzheon. The institution of Dr. Sabbagh has received research support from NIH. The institution of Dr. Sabbagh has received research support from ADDF.

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