Molecular imaging in the diagnosis of Alzheimer's disease: visual assessment of [11C]PIB and [18F]FDDNP PET images

Nelleke Tolboom; Wiesje M van der Flier; Jolanda Boverhoff; Maqsood Yaqub; Mike P Wattjes; Pieter G Raijmakers; Frederik Barkhof; Philip Scheltens; Karl Herholz; Adriaan A Lammertsma; Bart N M van Berckel

doi:10.1136/jnnp.2009.194779

Molecular imaging in the diagnosis of Alzheimer's disease: visual assessment of [11C]PIB and [18F]FDDNP PET images

Nelleke Tolboom^*
, Wiesje M van der Flier
, Jolanda Boverhoff
, Maqsood Yaqub
, Mike P Wattjes
, Pieter G Raijmakers
, Frederik Barkhof
, Philip Scheltens
, Karl Herholz
, Adriaan A Lammertsma
, Bart N M van Berckel

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To evaluate visual assessment of [(11)C]PIB and [(18)F]FDDNP PET images as potential supportive diagnostic markers for Alzheimer's disease (AD).

METHODS: Twenty-one AD patients and 20 controls were included. Parametric [(11)C]PIB and [(18)F]FDDNP global binding potential (BP(ND)) images were visually rated as 'AD' or 'normal.' Data were compared with ratings of [(18)F]FDG PET images and MRI-derived medial temporal lobe atrophy (MTA) scores. Inter-rater agreement and agreement with clinical diagnosis were assessed for all imaging modalities. In addition, cut-off values for quantitative global [(11)C]PIB and [(18)F]FDDNP BP(ND) were determined. Visual ratings were compared with dichotomised quantitative values.

RESULTS: Agreement between readers was excellent for [(11)C]PIB, [(18)F]FDDNP and MTA (Cohen kappa kappa> or =0.85) and moderate for [(18)F]FDG (kappa=0.56). The highest sensitivity was found for [(11)C]PIB and [(18)F]FDG (both 1.0). The highest specificity was found for MTA (0.90) and [(11)C]PIB (0.85). [(18)F]FDDNP had the lowest sensitivity and specificity (0.67 and 0.53, respectively). The cut-off for quantitative [(11)C]PIB BP(ND) was 0.54 (sensitivity and specificity both 0.95) and for [(18)F]FDDNP BP(ND) 0.07 (sensitivity 0.80, specificity 0.73). Agreement between quantitative analyses and visual ratings was excellent for [(11)C]PIB (kappa=0.85) and fair for [(18)F]FDDNP (kappa=0.40).

CONCLUSION: Visual assessment of [(11)C]PIB images was straightforward and accurate, showing promise as a supportive diagnostic marker for AD. Moreover, [(11)C]PIB showed the best combination of sensitivity and specificity. Visual assessment of [(18)F]FDDNP images was insufficient. The quantitative analysis of [(18)F]FDDNP data showed a considerably higher diagnostic value than the visual analysis.

Original language	English
Pages (from-to)	882-884
Number of pages	3
Journal	Journal of neurology, neurosurgery, and psychiatry
Volume	81
Issue number	8
DOIs	https://doi.org/10.1136/jnnp.2009.194779
Publication status	Published - Aug 2010
Externally published	Yes

Keywords

Aged
Alzheimer Disease/diagnosis
Aniline Compounds
Atrophy
Benzothiazoles
Brain Chemistry
Female
Fluorodeoxyglucose F18
Glucose/metabolism
Humans
Image Processing, Computer-Assisted
Likelihood Functions
Magnetic Resonance Imaging
Male
Middle Aged
Nitriles
Observer Variation
Positron-Emission Tomography
ROC Curve
Radiopharmaceuticals
Temporal Lobe/pathology
Thiazoles

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10.1136/jnnp.2009.194779

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Tolboom, N., van der Flier, W. M., Boverhoff, J., Yaqub, M., Wattjes, M. P., Raijmakers, P. G., Barkhof, F., Scheltens, P., Herholz, K., Lammertsma, A. A., & van Berckel, B. N. M. (2010). Molecular imaging in the diagnosis of Alzheimer's disease: visual assessment of [11C]PIB and [18F]FDDNP PET images. Journal of neurology, neurosurgery, and psychiatry, 81(8), 882-884. https://doi.org/10.1136/jnnp.2009.194779

@article{b07af0e5c0824a70bd9393839c880dd7,

title = "Molecular imaging in the diagnosis of Alzheimer's disease: visual assessment of [11C]PIB and [18F]FDDNP PET images",

abstract = "OBJECTIVE: To evaluate visual assessment of [(11)C]PIB and [(18)F]FDDNP PET images as potential supportive diagnostic markers for Alzheimer's disease (AD).METHODS: Twenty-one AD patients and 20 controls were included. Parametric [(11)C]PIB and [(18)F]FDDNP global binding potential (BP(ND)) images were visually rated as 'AD' or 'normal.' Data were compared with ratings of [(18)F]FDG PET images and MRI-derived medial temporal lobe atrophy (MTA) scores. Inter-rater agreement and agreement with clinical diagnosis were assessed for all imaging modalities. In addition, cut-off values for quantitative global [(11)C]PIB and [(18)F]FDDNP BP(ND) were determined. Visual ratings were compared with dichotomised quantitative values.RESULTS: Agreement between readers was excellent for [(11)C]PIB, [(18)F]FDDNP and MTA (Cohen kappa kappa> or =0.85) and moderate for [(18)F]FDG (kappa=0.56). The highest sensitivity was found for [(11)C]PIB and [(18)F]FDG (both 1.0). The highest specificity was found for MTA (0.90) and [(11)C]PIB (0.85). [(18)F]FDDNP had the lowest sensitivity and specificity (0.67 and 0.53, respectively). The cut-off for quantitative [(11)C]PIB BP(ND) was 0.54 (sensitivity and specificity both 0.95) and for [(18)F]FDDNP BP(ND) 0.07 (sensitivity 0.80, specificity 0.73). Agreement between quantitative analyses and visual ratings was excellent for [(11)C]PIB (kappa=0.85) and fair for [(18)F]FDDNP (kappa=0.40).CONCLUSION: Visual assessment of [(11)C]PIB images was straightforward and accurate, showing promise as a supportive diagnostic marker for AD. Moreover, [(11)C]PIB showed the best combination of sensitivity and specificity. Visual assessment of [(18)F]FDDNP images was insufficient. The quantitative analysis of [(18)F]FDDNP data showed a considerably higher diagnostic value than the visual analysis.",

keywords = "Aged, Alzheimer Disease/diagnosis, Aniline Compounds, Atrophy, Benzothiazoles, Brain Chemistry, Female, Fluorodeoxyglucose F18, Glucose/metabolism, Humans, Image Processing, Computer-Assisted, Likelihood Functions, Magnetic Resonance Imaging, Male, Middle Aged, Nitriles, Observer Variation, Positron-Emission Tomography, ROC Curve, Radiopharmaceuticals, Temporal Lobe/pathology, Thiazoles",

author = "Nelleke Tolboom and \{van der Flier\}, \{Wiesje M\} and Jolanda Boverhoff and Maqsood Yaqub and Wattjes, \{Mike P\} and Raijmakers, \{Pieter G\} and Frederik Barkhof and Philip Scheltens and Karl Herholz and Lammertsma, \{Adriaan A\} and \{van Berckel\}, \{Bart N M\}",

year = "2010",

month = aug,

doi = "10.1136/jnnp.2009.194779",

language = "English",

volume = "81",

pages = "882--884",

journal = "Journal of neurology, neurosurgery, and psychiatry",

issn = "0022-3050",

publisher = "BMJ Publishing Group",

number = "8",

}

Tolboom, N, van der Flier, WM, Boverhoff, J, Yaqub, M, Wattjes, MP, Raijmakers, PG, Barkhof, F, Scheltens, P, Herholz, K, Lammertsma, AA & van Berckel, BNM 2010, 'Molecular imaging in the diagnosis of Alzheimer's disease: visual assessment of [11C]PIB and [18F]FDDNP PET images', Journal of neurology, neurosurgery, and psychiatry, vol. 81, no. 8, pp. 882-884. https://doi.org/10.1136/jnnp.2009.194779

TY - JOUR

T1 - Molecular imaging in the diagnosis of Alzheimer's disease

T2 - visual assessment of [11C]PIB and [18F]FDDNP PET images

AU - Tolboom, Nelleke

AU - van der Flier, Wiesje M

AU - Boverhoff, Jolanda

AU - Yaqub, Maqsood

AU - Wattjes, Mike P

AU - Raijmakers, Pieter G

AU - Barkhof, Frederik

AU - Scheltens, Philip

AU - Herholz, Karl

AU - Lammertsma, Adriaan A

AU - van Berckel, Bart N M

PY - 2010/8

Y1 - 2010/8

N2 - OBJECTIVE: To evaluate visual assessment of [(11)C]PIB and [(18)F]FDDNP PET images as potential supportive diagnostic markers for Alzheimer's disease (AD).METHODS: Twenty-one AD patients and 20 controls were included. Parametric [(11)C]PIB and [(18)F]FDDNP global binding potential (BP(ND)) images were visually rated as 'AD' or 'normal.' Data were compared with ratings of [(18)F]FDG PET images and MRI-derived medial temporal lobe atrophy (MTA) scores. Inter-rater agreement and agreement with clinical diagnosis were assessed for all imaging modalities. In addition, cut-off values for quantitative global [(11)C]PIB and [(18)F]FDDNP BP(ND) were determined. Visual ratings were compared with dichotomised quantitative values.RESULTS: Agreement between readers was excellent for [(11)C]PIB, [(18)F]FDDNP and MTA (Cohen kappa kappa> or =0.85) and moderate for [(18)F]FDG (kappa=0.56). The highest sensitivity was found for [(11)C]PIB and [(18)F]FDG (both 1.0). The highest specificity was found for MTA (0.90) and [(11)C]PIB (0.85). [(18)F]FDDNP had the lowest sensitivity and specificity (0.67 and 0.53, respectively). The cut-off for quantitative [(11)C]PIB BP(ND) was 0.54 (sensitivity and specificity both 0.95) and for [(18)F]FDDNP BP(ND) 0.07 (sensitivity 0.80, specificity 0.73). Agreement between quantitative analyses and visual ratings was excellent for [(11)C]PIB (kappa=0.85) and fair for [(18)F]FDDNP (kappa=0.40).CONCLUSION: Visual assessment of [(11)C]PIB images was straightforward and accurate, showing promise as a supportive diagnostic marker for AD. Moreover, [(11)C]PIB showed the best combination of sensitivity and specificity. Visual assessment of [(18)F]FDDNP images was insufficient. The quantitative analysis of [(18)F]FDDNP data showed a considerably higher diagnostic value than the visual analysis.

AB - OBJECTIVE: To evaluate visual assessment of [(11)C]PIB and [(18)F]FDDNP PET images as potential supportive diagnostic markers for Alzheimer's disease (AD).METHODS: Twenty-one AD patients and 20 controls were included. Parametric [(11)C]PIB and [(18)F]FDDNP global binding potential (BP(ND)) images were visually rated as 'AD' or 'normal.' Data were compared with ratings of [(18)F]FDG PET images and MRI-derived medial temporal lobe atrophy (MTA) scores. Inter-rater agreement and agreement with clinical diagnosis were assessed for all imaging modalities. In addition, cut-off values for quantitative global [(11)C]PIB and [(18)F]FDDNP BP(ND) were determined. Visual ratings were compared with dichotomised quantitative values.RESULTS: Agreement between readers was excellent for [(11)C]PIB, [(18)F]FDDNP and MTA (Cohen kappa kappa> or =0.85) and moderate for [(18)F]FDG (kappa=0.56). The highest sensitivity was found for [(11)C]PIB and [(18)F]FDG (both 1.0). The highest specificity was found for MTA (0.90) and [(11)C]PIB (0.85). [(18)F]FDDNP had the lowest sensitivity and specificity (0.67 and 0.53, respectively). The cut-off for quantitative [(11)C]PIB BP(ND) was 0.54 (sensitivity and specificity both 0.95) and for [(18)F]FDDNP BP(ND) 0.07 (sensitivity 0.80, specificity 0.73). Agreement between quantitative analyses and visual ratings was excellent for [(11)C]PIB (kappa=0.85) and fair for [(18)F]FDDNP (kappa=0.40).CONCLUSION: Visual assessment of [(11)C]PIB images was straightforward and accurate, showing promise as a supportive diagnostic marker for AD. Moreover, [(11)C]PIB showed the best combination of sensitivity and specificity. Visual assessment of [(18)F]FDDNP images was insufficient. The quantitative analysis of [(18)F]FDDNP data showed a considerably higher diagnostic value than the visual analysis.

KW - Aged

KW - Alzheimer Disease/diagnosis

KW - Aniline Compounds

KW - Atrophy

KW - Benzothiazoles

KW - Brain Chemistry

KW - Female

KW - Fluorodeoxyglucose F18

KW - Glucose/metabolism

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Likelihood Functions

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Nitriles

KW - Observer Variation

KW - Positron-Emission Tomography

KW - ROC Curve

KW - Radiopharmaceuticals

KW - Temporal Lobe/pathology

KW - Thiazoles

U2 - 10.1136/jnnp.2009.194779

DO - 10.1136/jnnp.2009.194779

M3 - Article

C2 - 20543188

SN - 0022-3050

VL - 81

SP - 882

EP - 884

JO - Journal of neurology, neurosurgery, and psychiatry

JF - Journal of neurology, neurosurgery, and psychiatry

IS - 8

ER -

Molecular imaging in the diagnosis of Alzheimer's disease: visual assessment of [11C]PIB and [18F]FDDNP PET images

Abstract

Keywords

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