A European multicentre PET study of fibrillar amyloid in Alzheimer%26apos;s disease

作者：Nordberg Agneta^*; Carter Stephen F; Rinne Juha; Drzezga Alexander; Brooks David J; Vandenberghe Rik; Perani Daniela; For**erg Anton; Langstrom Bengt; Scheinin Noora; Karrasch Mira; Nagren Kjell; Grimmer Timo; Miederer Isabelle; Edison Paul; Okello Aren; Van Laere Koen; Nelissen Natalie; Vandenbulcke Mathieu; Garibotto Valentina; Almkvist Ove; Kalbe Elke; Hinz Rainer; Herholz Karl

来源：European Journal of Nuclear Medicine and Molecular Imaging, 2013, 40(1): 104-114.

DOI：10.1007/s00259-012-2237-2

• Amyloid
• Multicentre PET
• PIB
• MCI
• Alzheimer%26apos
• s disease
• Mild cognitive impairment
• Cognition

Amyloid PET tracers have been developed for in vivo detection of brain fibrillar amyloid deposition in Alzheimer%26apos;s disease (AD). To serve as an early biomarker in AD the amyloid PET tracers need to be analysed in multicentre clinical studies. %26lt;br%26gt;In this study 238 [C-11]Pittsburgh compound-B (PIB) datasets from five different European centres were pooled. Of these 238 datasets, 18 were excluded, leaving [C-11]PIB datasets from 97 patients with clinically diagnosed AD (mean age 69 +/- 8 years), 72 patients with mild cognitive impairment (MCI; mean age 67.5 +/- 8 years) and 51 healthy controls (mean age 67.4 +/- 6 years) available for analysis. Of the MCI patients, 64 were longitudinally followed for 28 +/- 15 months. Most participants (175 out of 220) were also tested for apolipoprotein E (ApoE) genotype. %26lt;br%26gt;[C-11]PIB retention in the neocortical and subcortical brain regions was significantly higher in AD patients than in age-matched controls. Intermediate [C-11]PIB retention was observed in MCI patients, with a bimodal distribution (64 % MCI PIB-positive and 36 % MCI PIB-negative), which was significantly different the pattern in both the AD patients and controls. Higher [C-11]PIB retention was observed in MCI ApoE epsilon 4 carriers compared to non-ApoE epsilon 4 carriers (p %26lt; 0.005). Of the MCI PIB-positive patients, 67 % had converted to AD at follow-up while none of the MCI PIB-negative patients converted. %26lt;br%26gt;This study demonstrated the robustness of [C-11]PIB PET as a marker of neocortical fibrillar amyloid deposition in brain when assessed in a multicentre setting. MCI PIB-positive patients showed more severe memory impairment than MCI PIB-negative patients and progressed to AD at an estimated rate of 25 % per year. None of the MCI PIB-negative patients converted to AD, and thus PIB negativity had a 100 % negative predictive value for progression to AD. This supports the notion that PIB-positive scans in MCI patients are an indicator of prodromal AD.

• 出版日期2013-1