Amyloid-Positronenemissionstomographie mit [18 F]-Florbetaben in der Demenzdiagnostik

Schönecker, Sonja; Prix, Catharina; Raiser, Theresa; Ackl, Nibal; Wlasich, Elisabeth; Stenglein-Krapf, Gisela; Mille, Erik; Brendel, Matthias; Sabri, Osama; Patt, Marianne; Barthel, Henryk; Bartenstein, Peter; Xiong, Chengjie; Rominger, Axel; Danek, Adrian

doi:10.1007/s00115-016-0249-z

Cited by 10 publications

(10 citation statements)

References 34 publications

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“…Sixteen studies concerning the clinical utility of amyloid PET imaging were found in the literature (17,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Supplemental Table 3 summarizes these studies.…”

Section: Clinical Utility Of Amyloid Imagingmentioning

confidence: 99%

Clinical Use and Utility of Amyloid Imaging

Barthel

Sabri

2017

J Nucl Med

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Currently, 3 amyloid PET tracers are approved and commercially available for clinical use. They allow for the accurate in vivo detection of amyloid plaques, one hallmark of Alzheimer disease. Here, we review the current knowledge on the clinical use and utility of amyloid imaging. Appropriate use criteria for the clinical application of amyloid imaging are established, and most currently available data point to their validity. Visual amyloid image analysis is highly standardized. Disclosure of amyloid imaging results is desired by many cognitively impaired subjects and seems to be safe once appropriate education is delivered to the disclosing clinicians. Regarding clinical utility, increasing evidence points to a change in diagnosis via amyloid imaging in about 30% of cases, to an increase in diagnostic confidence in about 60% of cases, to a change in patient management in about 60% of cases, and specifically to a change in medication in about 40% of cases. Also, amyloid imaging results seem to have a relevant impact on caregivers. Further, initial simulation studies point to a potential positive effect on patient outcome and to cost effectiveness of amyloid imaging. These features, however, will require confirmation in prospective clinical trials. More work is also required to determine the clinical utility of amyloid imaging specifically in subjects with mild cognitive impairment and in comparison with or in conjunction with other Alzheimer disease biomarkers. In summary, the clinical use of amyloid imaging is being studied, and the currently available data point to a relevant clinical utility of this imaging technique. Ongoing research will determine whether this accurate and noninvasive approach to amyloid plaque load detection will translate into a benefit to cognitively impaired subjects. Wi th the successful development and subsequent clinical approval of 18 F-florbetapir, 18 F-florbetaben, and 18 F-flutemetamol, the nuclear imaging community has a set of b-amyloid aggregatetargeting PET tracers in hand for clinical use. They allow the in vivo detection or exclusion of neuritic b-amyloid plaques, one histopathologic hallmark in the neocortex of patients with Alzheimer disease (AD), which previously could be diagnosed only histopathologically after death. Of note, brain b-amyloid accumulation is known to be an early event in this disease (1) and is considered by many as the initial trigger of a cascade of other pathobiochemical and pathophysiologic alterations finally leading to neurodegeneration and related cognitive decline in AD (2).The emergence of amyloid imaging technology is hoped to fill a relevant diagnostic gap in the clinic in cognitively impaired subjects and in AD in particular. Most people would like to get a diagnosis when cognitive symptoms are identified (3). Conversely, dementia diagnosis is often missed and delayed (4,5). With regard to the therapeutic implications of an AD diagnosis, it was reported that older people are willing to accept the relevant side effects of AD-modifying therap...

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Section: Clinical Utility Of Amyloid Imagingmentioning

confidence: 99%

Clinical Use and Utility of Amyloid Imaging

Barthel

Sabri

2017

J Nucl Med

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“…Recently, research criteria for detection of AD have emphasised the importance of amyloid and tau positron emission tomography (PET) imaging biomarkers [2,3]. 11 C-Pittsburgh Compound B ( 11 C-PiB), 18 F-florbetaben (FBB), 18 F-florbetapir, 18 F-flutemetamol and 18 F-NAV4694 (NAV) are PET tracers that demonstrate binding to brain Aβ in AD from the preclinical AD stage onwards, with good sensitivity and specificity as biomarkers of antemortem AD pathology and predictors of progression to AD dementia [4][5][6][7][8][9][10]. Amyloid PET scans are used for inclusion and monitoring in AD-modifying clinical therapy trials and to aid clinical diagnosis and prognostication [11,12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of amyloid PET measured in Centiloid units with neuropathological findings in Alzheimer’s disease

et al. 2020

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Background: The Centiloid scale was developed to standardise the results of beta-amyloid (Aβ) PET. We aimed to determine the Centiloid unit (CL) thresholds for CERAD sparse and moderate-density neuritic plaques, Alzheimer's disease neuropathologic change (ADNC) score of intermediate or high probability of Alzheimer's Disease (AD), final clinicopathological diagnosis of AD, and expert visual read of a positive Aβ PET scan. Methods: Aβ PET results in CL for 49 subjects were compared with post-mortem findings, visual read, and final clinicopathological diagnosis. The Youden Index was used to determine the optimal CL thresholds from receiver operator characteristic (ROC) curves. Results: A threshold of 20.1 CL (21.3 CL when corrected for time to death, AUC 0.97) yielded highest accuracy in detecting moderate or frequent plaque density while < 10 CL was optimal for excluding neuritic plaque. The threshold for ADNC intermediate or high likelihood AD was 49.4 CL (AUC 0.98). Those cases with a final clinicopathological diagnosis of AD yielded a median CL result of 87.7 (IQR ± 42.2) with 94% > 45 CL. Positive visual read agreed highly with results > 26 CL. Conclusions: Centiloid values < 10 accurately reflected the absence of any neuritic plaque and > 20 CL indicated the presence of at least moderate plaque density, but approximately 50 CL or more best confirmed both neuropathological and clinicopathological diagnosis of Alzheimer's disease.

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“…In this report, the German psychiatrist Schonecker described bucco-oral movements persisting after treatment with neuroleptics. 1 This publication prompted a flood of articles describing motor disturbances induced by different antipsychotics; however, the term tardive dyskinesia (TD) appeared only in the mid-1960s. 2 The word 'tardive' refers to the delayed onset of motor disturbances following treatment with psychotropic medications.…”

mentioning

confidence: 99%

Tardive dyskinesia (syndrome): Current concept and modern approaches to its management

Lerner

Miodownik

Lerner

2015

Psychiatry Clin Neurosci

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Tardive dyskinesia is a serious, disabling and potentially permanent, neurological hyperkinetic movement disorder that occurs after months or years of taking psychotropic drugs. The pathophysiology of tardive dyskinesia is complex, multifactorial and still not fully understood. A number of drugs were tried for the management of this motor disturbance, yet until now no effective and standard treatment has been found. It is very disappointing to realize that the introduction of antipsychotics from the second generation has not significantly decreased the prevalence and incidence of tardive dyskinesia. Therefore, the management of this motor disturbance remains an actual topic as well as a challenge for clinicians. This review summarizes recent relevant publications concerning the treatment of tardive dyskinesia.

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Amyloid-Positronenemissionstomographie mit [18 F]-Florbetaben in der Demenzdiagnostik

Cited by 10 publications

References 34 publications

Clinical Use and Utility of Amyloid Imaging

Clinical Use and Utility of Amyloid Imaging

Comparison of amyloid PET measured in Centiloid units with neuropathological findings in Alzheimer’s disease

Tardive dyskinesia (syndrome): Current concept and modern approaches to its management

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