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Abstract Details

Positive PIB-PET Is Associated with High Post-Mortem Amyloid Burden in Dementia Patients
Aging and Dementia
IN3 - (-)
007
The diagnostic accuracy of amyloid imaging compared to autopsy diagnosis has not been established in typical clinical populations.
20 dementia patients underwent PIB-PET (age 67.3卤10.5), 80% male) and autopsy (2.6卤1.4 years after PET). Clinical diagnoses included Alzheimer's disease (AD, N=5), frontotemporal dementia (FTD, N=13), mild cognitive impairment (N=1) and prion disease (N=1). PIB distribution volume ratio (DVR) images were visually assessed as PIB+/PIB- blinded to clinical diagnosis. PIB binding was assessed using a global measure (PIB Index) and in six regions sampled at autopsy. Autopsies were performed at UCSF, Penn and UCLA using local protocols. Amyloid assessment at autopsy included Abeta immunohistochemistry (N=15), Bielschowsky (N=3) and Thioflavin-S staining (N=1). Global and regional neuritic plaques (NPs) were graded with modified CERAD (unadjusted for age).
Pathology diagnoses included: 8 NIA-Reagan high-likelihood AD (1 mixed with FTLD), 6 FTLD-TDP, 4 FTLD-Tau, 1 argyrophilic grain and 1 prion disease. All high and one low-likelihood AD patient had PIB+ scans, whilst one intermediate and all other absent to low-likelihood AD patients were PIB-. All CERAD-frequent patients (N=8) were visually rated as PIB+ and had a high PIB Index (mean=1.53卤0.33). All patients with CERAD-absent (N=5) or sparse-moderate NPs (N=6) had low PIB Index (mean=0.98卤0.05) and were PIB- (10), except one CERAD-sparse case who was PIB+ due to subtle focal uptake. No CERAD information was available in one case (prion). Regional PIB uptake was significantly higher in CERAD-frequent than CERAD-absent or sparse/intermediate samples in middle frontal, inferior temporal, angular and anterior cingulate gyri (p<0.05).
PIB+ scans reflect high burden of amyloid pathology, corresponding to CERAD-frequent/NIA-Reagan high-likelihood AD. These findings suggest high specificity when applying PIB-PET to differential diagnosis, and potentially in preclinical detection of AD.
Authors/Disclosures
Manja Lehmann, PhD (U of California San Francisco)
PRESENTER 		No disclosure on file
William W. Seeley, MD Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG Council. Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global Consulting. Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BridgeBio. Dr. Seeley has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Seeley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lyterian Therapeutics. The institution of Dr. Seeley has received research support from NIH. The institution of Dr. Seeley has received research support from Rainwater Charitable Foundation. The institution of Dr. Seeley has received research support from Bluefield Project to Cure FTD. The institution of Dr. Seeley has received research support from Chan-Zuckerberg Initiative.
Ibon Garitaonandia (International Stem Cell Corporation) No disclosure on file
No disclosure on file
No disclosure on file
Bruce L. Miller, MD, FAAN (University of California, San Francisco) Dr. Miller has nothing to disclose.
No disclosure on file
John Q. Trojanowski, MD, PhD (University of PA School of Med) Dr. Trojanowski has nothing to disclose.
Mario F. Mendez, MD, PhD, FAAN (VA Greater Los Angeles Healthcare System and UCLA) Dr. Mendez has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medical 好色先生 Speakers' Bureau. Dr. Mendez has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for UpToDate. The institution of Dr. Mendez has received research support from NIH. Dr. Mendez has received publishing royalties from a publication relating to health care.
Harry Vinters No disclosure on file
William Jagust, MD (Helen Wills Neuroscience Institute) No disclosure on file
Gil D. Rabinovici, MD, FAAN (UCSF Memory & Aging Center) Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alector. Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Norodisk. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for C2N. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Joihnson. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Peerview. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medscape. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA. The institution of Dr. Rabinovici has received research support from NIH. The institution of Dr. Rabinovici has received research support from American College of Radiology. The institution of Dr. Rabinovici has received research support from Alzheimer's Association. The institution of Dr. Rabinovici has received research support from Rainwater Charitable Foundation. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Topic Chair, Course Director and teacher with AAN. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Invited speaker with ANA.