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Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease.

Publication ,  Journal Article
Fleisher, AS; Chen, K; Liu, X; Roontiva, A; Thiyyagura, P; Ayutyanont, N; Joshi, AD; Clark, CM; Mintun, MA; Pontecorvo, MJ; Doraiswamy, PM ...
Published in: Arch Neurol
November 2011

OBJECTIVES: To characterize quantitative florbetapir F 18 (hereafter referred to as simply florbetapir) positron emission tomographic (PET) measurements of fibrillar β-amyloid (Aβ) burden in a large clinical cohort of participants with probable Alzheimer disease (AD) or mild cognitive impairment (MCI) and older healthy controls (OHCs). DESIGN: Cerebral-to-whole-cerebellar florbetapir standard uptake value ratios (SUVRs) were computed. Mean cortical SUVRs were compared. A threshold of SUVRs greater than or equal to 1.17 was used to reflect pathological levels of amyloid associated with AD based on separate antemortem PET and postmortem neuropathology data from 19 end-of-life patients. Similarly, a threshold of SUVRs greater than 1.08 was used to signify the presence of any identifiable Aβ because this was the upper limit from a separate set of 46 individuals 18 to 40 years of age who did not carry apolipoprotein E (APOE) ε4. SETTING: Multiple research imaging centers. PARTICIPANTS: A total of 68 participants with probable AD, 60 participants with MCI, and 82 OHCs who were 55 years of age or older. Main Outcome Measure Florbetapir-PET activity. RESULTS: All of the participants (ie, those with probable AD or MCI and those who were OHCs) differed significantly in mean (SD) cortical florbetapir SUVRs (1.39 [0.24], 1.17 [0.27], and 1.05 [0.16], respectively; P < 1.0 × 10⁻⁷), in percentage meeting levels of amyloid associated with AD by SUVR criteria (80.9%, 40.0%, and 20.7%, respectively; P < 1.0 × 10⁻⁷), and in percentage meeting SUVR criteria for the presence of any identifiable Aβ (85.3%, 46.6%, and 28.1%, respectively; P < 1.0 × 10⁻⁷). Among OHCs, the percentage of florbetapir positivity increased linearly by age decile (P = .05). For the 54 OHCs with available APOE genotypes, APOE ε4 carriers had a higher mean (SD) cortical SUVR than did noncarriers (1.14 [0.2] vs 1.03 [0.16]; P = .048). CONCLUSIONS: The findings of our analysis confirm the ability of florbetapir-PET SUVRs to characterize amyloid levels in clinically probable AD, MCI, and OHC groups using continuous and binary measures of fibrillar Aβ burden. It introduces criteria to determine whether an image is associated with an intermediate-to-high likelihood of pathologic AD or with having any identifiable cortical amyloid level above that seen in low-risk young controls.

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Published In

Arch Neurol

DOI

EISSN

1538-3687

Publication Date

November 2011

Volume

68

Issue

11

Start / End Page

1404 / 1411

Location

United States

Related Subject Headings

  • Young Adult
  • Positron-Emission Tomography
  • Plaque, Amyloid
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Fluorine Radioisotopes
  • Ethylene Glycols
  • Dementia
 

Citation

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ICMJE
MLA
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Fleisher, A. S., Chen, K., Liu, X., Roontiva, A., Thiyyagura, P., Ayutyanont, N., … Reiman, E. M. (2011). Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease. Arch Neurol, 68(11), 1404–1411. https://doi.org/10.1001/archneurol.2011.150
Fleisher, Adam S., Kewei Chen, Xiaofen Liu, Auttawut Roontiva, Pradeep Thiyyagura, Napatkamon Ayutyanont, Abhinay D. Joshi, et al. “Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease.Arch Neurol 68, no. 11 (November 2011): 1404–11. https://doi.org/10.1001/archneurol.2011.150.
Fleisher AS, Chen K, Liu X, Roontiva A, Thiyyagura P, Ayutyanont N, et al. Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease. Arch Neurol. 2011 Nov;68(11):1404–11.
Fleisher, Adam S., et al. “Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease.Arch Neurol, vol. 68, no. 11, Nov. 2011, pp. 1404–11. Pubmed, doi:10.1001/archneurol.2011.150.
Fleisher AS, Chen K, Liu X, Roontiva A, Thiyyagura P, Ayutyanont N, Joshi AD, Clark CM, Mintun MA, Pontecorvo MJ, Doraiswamy PM, Johnson KA, Skovronsky DM, Reiman EM. Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease. Arch Neurol. 2011 Nov;68(11):1404–1411.

Published In

Arch Neurol

DOI

EISSN

1538-3687

Publication Date

November 2011

Volume

68

Issue

11

Start / End Page

1404 / 1411

Location

United States

Related Subject Headings

  • Young Adult
  • Positron-Emission Tomography
  • Plaque, Amyloid
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Fluorine Radioisotopes
  • Ethylene Glycols
  • Dementia