Ossenkoppele R, Rabinovici GD, Smith R, Cho H, Schöll M, Strandberg O, Palmqvist S, Mattsson N, Janelidze S, Santillo A, Ohlsson T, Jögi J, Tsai R, La Joie R, Kramer J, Boxer AL, Gorno-Tempini ML, Miller BL, Choi JY, Ryu YH, Lyoo CH, Hansson O. Discriminative Accuracy of [18F]flortaucipir Positron Emission Tomography for Alzheimer Disease vs Other Neurodegenerative Disorders. JAMA. 2018 Sep 18;320(11):1151-1162. PubMed.
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University of Pittsburgh
This is a large, well-done study of 719 patients overall and 254 with suspected non-AD disorders from a diverse group of three sites around the world. The tau-PET data is supplemented by amyloid-PET data. The sensitivity/specificity (90/91 percent and 97/88 percent by two different measures) were impressive and substantially better than volumetric MR measures. The study produced volumes-of-interest and cutoffs that have extrinsic merit as well. While the diagnostic discrimination was impressive for the main purpose of distinguishing non-AD disorders from clinical AD, the performance was not as impressive in MCI due to AD (i.e., Aβ + MCI). This is likely a reflection of the later nature of tau deposition in the pathophysiological sequence of events in AD and points to the fact that different biomarkers have different “sweet spots” along this sequence of events.
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