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• W4248606690 abstract "We compared the diagnostic performance of β-Amyloid (PIB) PET and FDG-PET in a large, clinical population with autopsy-proven diagnosis. We included 95 individuals with diverse clinical syndromes that underwent PIB and FDG-PET and post-mortem assessment (Table 1). All scans were visually read by three raters blinded to clinical information. PIB and FDG scans were read separately blinded to the results of the other scan. PIB scans were rated as positive or negative for cortical retention while FDG scans were read as showing an AD or non-AD pattern (Figure 2). AD neuropathological changes (ADNC) were measured at autopsy in all cases, with cases further divided into pure-AD (intermediate-high ADNC), mixed AD-non-AD, and pure non-AD pathology. Majority visual reads (2/3 raters) and quantitative PIB (mean cortical SUVR>1.4) were compared to intermediate-high ADNC as the gold standard. Consensus (full agreement between raters) and majority (2/3 raters in agreement) PIBvisual reads vs. PIB quantification in different neuropathology diagnoses (AD only, mix AD-nonAD and non-AD only pathology). Selected patient, Pt.1-3, are highlighted and their imaging and autopsy findings are presented at Figure 2. PIB and FDG consensus visual read and autopsy classification of three selected patients. Patient 1: PIB and FDG congruent on AD pattern. Patient 2: PIB and FDG congruent on non-AD pattern. Patient 3: PIB and FDG non-congruent. PIBvisual showed higher sensitivity in detecting intermediate-to-high ADNC (95% vs 76% for FDGvisual, McNemar p=0.01) and higher negative predictive value (96% vs 81%, p=0.01), but equivalent specificity (85% vs 81%, p=0.59) (Table 2). PIBquantification had higher specificity (p=0.025) and positive predictive value (p=0.02) compared to PIBvisual. 78/95 cases had consensus (full-agreement between raters) PIB reads, while 66/95 cases had consensus FDG reads. Inter-rater agreement was higher for PIBvisual (Fleiss’ Kappa=0.761) than FDGvisual (Kappa=0.586), P=0.025. The performance of PIBvisual is presented in Figure 1. Most (n=5) “false positive” cases (n=8) had moderate-to-high CERAD but low Braak stages. False negative cases (n=2) also had sub-threshold PIBquantification (<1.4). Sensitivity to detect intermediate-to-high ADNC was 97% (CI:83-100%) and specificity 95% (CI:83-100%) for individuals that had congruent PIBvisual and FDGvisual (71/95 patients, examples in Figure 2). When PIB and FDG were incongruent (n=24): PIB was correct in 9 cases, FDG was correct in 6 cases and both were correct in 9 cases in which there was co-pathology of AD and non-AD pathologies. In our cohort of 95 patients with autopsy proven diagnosis, PIB-PET had higher sensitivity in predicting AD pathology compared to FDG-PET, with similar specificity. When PIB and FDG are congruent, sensitivity and specificity approaches 100%. Mixed pathology should be considered when PIB and FDG are incongruent." @default.
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• W4248606690 date "2018-07-01" @default.
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• W4248606690 title "O4‐09‐02: HEAD‐TO‐HEAD COMPARISON OF PIB AND FDG‐PET IN AUTOPSY‐CONFIRMED CASES" @default.
• W4248606690 doi "https://doi.org/10.1016/j.jalz.2018.06.2958" @default.
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