Comparing ATN-T designation by tau PET visual reads, tau PET quantification, and CSF PTau181 across three cohorts

Research output: Contribution to journalArticle

Abstract

Purpose: To compare rates of tau biomarker positivity (T-status) per the 2018 Alzheimer’s Disease (AD) Research Framework derived from [18F]flortaucipir (FTP) PET visual assessment, FTP quantification, and cerebrospinal fluid (CSF) phosphorylated Tau-181 (PTau181). Methods: We included 351 subjects with varying clinical diagnoses from three cohorts with available FTP PET and CSF PTau181 within 18 months. T-status was derived from (1) FTP visual assessment by two blinded raters; (2) FTP standardized uptake value ratio (SUVR) quantification from a temporal meta-ROI (threshold: SUVR ≥1.27); and (3) Elecsys® Phospho-Tau (181P) CSF (Roche Diagnostics) concentrations (threshold: PTau181 ≥ 24.5 pg/mL). Results: FTP visual reads yielded the highest rates of T+, while T+ by SUVR increased progressively from cognitively normal (CN) through mild cognitive impairment (MCI) and AD dementia. T+ designation by CSF PTau181 was intermediate between FTP visual reads and SUVR values in CN, similar to SUVR in MCI, and lower in AD dementia. Concordance in T-status between modality pairs ranged from 68 to 76% and varied by clinical diagnosis, being highest in patients with AD dementia. In discriminating Aβ + MCI and AD subjects from healthy controls and non-AD participants, FTP visual assessment was most sensitive (0.96) but least specific (0.60). Specificity was highest with FTP SUVR (0.91) with sensitivity of 0.89. Sensitivity (0.73) and specificity (0.72) were balanced for PTau181. Conclusion: The choice of tau biomarker may differ by disease stage and research goals that seek to maximize sensitivity or specificity. Visual interpretations of tau PET enhance sensitivity compared to quantification alone, particularly in early disease stages.

Details

Authors
  • Karine Provost
  • Leonardo Iaccarino
  • David N. Soleimani-Meigooni
  • Suzanne Baker
  • Lauren Edwards
  • Udo Eichenlaub
  • Oskar Hansson
  • William Jagust
  • Mustafa Janabi
  • Renaud La Joie
  • Orit Lesman-Segev
  • Taylor J. Mellinger
  • Bruce L. Miller
  • Rik Ossenkoppele
  • Julie Pham
  • Ruben Smith
  • Ida Sonni
  • Amelia Strom
  • Niklas Mattsson-Carlgren
  • Gil D. Rabinovici
  • Alzheimer’S Disease Neuroimaging Initiative (Adni)
Organisations
External organisations
  • University of California, San Francisco
  • Lawrence Berkeley National Laboratory
  • Roche Diagnostics, Germany
  • University of California, Berkeley
  • Amsterdam UMC - Vrije Universiteit Amsterdam
  • Vrije Universiteit Amsterdam
  • University of California, Los Angeles
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Radiology, Nuclear Medicine and Medical Imaging
  • Neurology

Keywords

  • Alzheimer’s disease, Biomarkers, CSF, Flortaucipir, PET, Tau
Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Publication statusE-pub ahead of print - 2021 Jan 4
Publication categoryResearch
Peer-reviewedYes