A beta imaging with 18F-florbetaben in prodromal Alzheimer's disease: a prospective outcome study

作者：Ong Kevin T; Villemagne Victor L; Bahar Fuchs Alex; Lamb Fiona; Langdon Narelle; Catafau Ana M; Stephens Andrew W; Seibyl John; Dinkelborg Ludger M; Reininger Cornelia B; Putz Barbara; Rohde Beate; Masters Colin L; Rowe Christopher C^*

来源：Journal of Neurology Neurosurgery and Psychiatry, 2015, 86(4): 431-436.

DOI：10.1136/jnnp-2014-308094

Background We assessed the clinical utility of beta-amyloid (A beta) imaging with F-18-florbetaben (FBB) in mild cognitive impairment (MCI) by evaluating its prognostic accuracy for progression to Alzheimer's disease (AD), comparing semiquantitative with visual scan assessment, and exploring the relationships among A beta, hippocampal volume (HV) and memory over time.
Methods 45 MCI underwent FBB positron emission tomography, MRI and neuropsychological assessment at baseline and 2 years and clinical follow-up at 4 years. Positive FBB (FBB+), defined by a cortical to cerebellar cortex standardised uptake value ratio (SUVR) >= 1.45, was compared with visual assessment by five readers. Amnestic MCI (aMCI) was defined by a composite episodic memory (EM) Z-score of <-1.5.
Results At baseline, 24 (53%) MCI were FBB+. Majority reads agreed with SUVR classification (kappa 0.96). In 2 years, 18 (75%) FBB+ progressed to AD compared with 2 (9.5%) FBB-, yielding a predictive accuracy of 83% (95% CI 61% to 94%). Four FBB-developed non-AD dementia. Predictive accuracies of HV (58% (95% CI 42% to 73%)) and aMCI status (73% (95% CI 58% to 81%)) were lower. Combinations did not improve accuracy. By 4 years, 21 (87.5%) FBB+ had AD whereas 5 (24%) FBB-had non-AD dementia yielding a predictive accuracy of 94% (95% CI 74% to 99%). While the strong baseline association between FBB SUVR and EM declined over 2 years, the association between EM and HV became stronger. FBB SUVR increased 2.2%/year in FBB+ with no change in FBB-.
Conclusions F-18-florbetaben A beta imaging facilitates accurate detection of prodromal AD. As neurodegeneration progresses, and in contrast with the early stages of the disease, hippocampal atrophy and not A beta, seems to drive memory decline.

• 出版日期2015-4