Background:Evidence suggests that the concordance between amyloid-PET and cerebrospinal fluid (CSF) amyloid-β (Aβ) increases when the CSF Aβ1–42/Aβ1–40 ratio is used as compared to CSF Aβ1–42 levels alone.Objective:In order to test this hypothesis, we set up a prospective longitudinal study comparing the concordance between different amyloid biomarkers for Alzheimer’s disease (AD) in a clinical setting.Methods:Seventy-eight subjects (AD dementia (n = 17), mild cognitive impairment (MCI, n = 48), and cognitively healthy controls (n = 13)) underwent a [18F]Florbetapir ([18F]AV45) PET scan, [18F]FDG PET scan, MRI scan, and an extensive neuropsychological examination. In a large subset (n = 67), a lumbar puncture was performed and AD biomarkers were analyzed (Aβ1–42, Aβ1–40, T-tau, P-tau181).Results:We detected an increased concordance in the visual and quantitative (standardized uptake value ratio (SUVR) and total volume of distribution (VT)) [18F]AV45 PET measures when the CSF Aβ1–42/Aβ1–40 was applied compared to Aβ1–42 alone. CSF biomarkers were stronger associated to [18F]AV45 PET for SUVR values when considering the total brain white matter as reference region instead of cerebellar grey matterConclusions:The concordance between CSF Aβ and [18F]AV45 PET increases when the CSF Aβ1–42/Aβ1–40 ratio is applied. This finding is of most importance for the biomarker-based diagnosis of AD as well as for selection of subjects for clinical trials with potential disease-modifying therapies for AD.
A local breast cancer recurrence or a new breast cancer in the previously treated breast is a staging challenge. Staging is important to tailor the local and the systemic treatment. Earlier treatment(s) can disrupt the primary lymphatic drainage. After the disruption, new lymphatic drainage pathways are often created. The identification of these new pathways together with their sentinel node(s) (SN) is important for retreatment. A fluorodeoxyglucose positron emission tomography-computerized tomography could be useful to identify the involved node(s), but, unfortunately, there is no evidence to support this. Ideally, in the case of a recurrence, an SN biopsy should be performed in order to identify the “new” draining lymph node(s). This new draining SN(s) can be located in unexpected places, and tumor invasion will lead to a change in the management.
A right atrial mass was discovered with transthoracic cardiac ultrasound in a complaint-free, 81-year-old man at his yearly cardiological checkup. Further investigation of the mass with transesophageal cardiac ultrasound showed a well-defined nodular mass of approximately 3 × 3 cm, in close proximity to the posterior wall of the right atrium. The patient underwent an 18F-FDG PET/CT, which showed a right atrial mass with very high FDG uptake, suggesting a malignant process. The mass was surgically removed, and anatomopathological assessment revealed an intimal sarcoma, which is a very malignant tumor and an extremely rare occurrence at this location.
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