Purpose: Assess the individual and combined diagnostic value of amyloid-PET and tau-PET in a memory clinic population. Methods: Clinical reports of 136 patients were randomly assigned to two diagnostic pathways: AMY-TAU, amyloid-PET is presented before tau-PET; and TAU-AMY, tau-PET is presented before amyloid-PET. Two neurologists independently assessed all reports with a balanced randomized design, and expressed etiological diagnosis and diagnostic confidence (50–100%) three times: (i) at baseline based on the routine diagnostic workup, (ii) after the first exam (amyloid-PET for the AMY-TAU pathway, and tau-PET for the TAU-AMY pathway), and (iii) after the remaining exam. The main outcomes were changes in diagnosis (from AD to non-AD or vice versa) and in diagnostic confidence. Results: Amyloid-PET and tau-PET, when presented as the first exam, resulted in a change of etiological diagnosis in 28% (p = 0.006) and 28% (p < 0.001) of cases, and diagnostic confidence increased by 18% (p < 0.001) and 19% (p < 0.001) respectively, with no differences between exams (p > 0.05). We observed a stronger impact of a negative amyloid-PET versus a negative tau-PET (p = 0.014). When added as the second exam, amyloid-PET and tau-PET resulted in a further change in etiological diagnosis in 6% (p = 0.077) and 9% (p = 0.149) of cases, and diagnostic confidence increased by 4% (p < 0.001) and 5% (p < 0.001) respectively, with no differences between exams (p > 0.05). Conclusion: Amyloid-PET and tau-PET significantly impacted diagnosis and diagnostic confidence in a similar way, although a negative amyloid-PET has a stronger impact on diagnosis than a negative tau-PET. Adding either of the two as second exam further improved diagnostic confidence. Trial number: PB 2016-01346.

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison / Altomare, Daniele; Caprioglio, Camilla; Assal, Frédéric; Allali, Gilles; Mendes, Aline; Ribaldi, Federica; Ceyzeriat, Kelly; Martins, Marta; Tomczyk, Szymon; Stampacchia, Sara; Dodich, Alessandra; Boccardi, Marina; Chicherio, Christian; Frisoni, Giovanni B.; Garibotto, Valentina. - In: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - ISSN 1619-7070. - 48:7(2021), pp. 2200-2211. [10.1007/s00259-021-05246-x]

Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison

Dodich, Alessandra;
2021-01-01

Abstract

Purpose: Assess the individual and combined diagnostic value of amyloid-PET and tau-PET in a memory clinic population. Methods: Clinical reports of 136 patients were randomly assigned to two diagnostic pathways: AMY-TAU, amyloid-PET is presented before tau-PET; and TAU-AMY, tau-PET is presented before amyloid-PET. Two neurologists independently assessed all reports with a balanced randomized design, and expressed etiological diagnosis and diagnostic confidence (50–100%) three times: (i) at baseline based on the routine diagnostic workup, (ii) after the first exam (amyloid-PET for the AMY-TAU pathway, and tau-PET for the TAU-AMY pathway), and (iii) after the remaining exam. The main outcomes were changes in diagnosis (from AD to non-AD or vice versa) and in diagnostic confidence. Results: Amyloid-PET and tau-PET, when presented as the first exam, resulted in a change of etiological diagnosis in 28% (p = 0.006) and 28% (p < 0.001) of cases, and diagnostic confidence increased by 18% (p < 0.001) and 19% (p < 0.001) respectively, with no differences between exams (p > 0.05). We observed a stronger impact of a negative amyloid-PET versus a negative tau-PET (p = 0.014). When added as the second exam, amyloid-PET and tau-PET resulted in a further change in etiological diagnosis in 6% (p = 0.077) and 9% (p = 0.149) of cases, and diagnostic confidence increased by 4% (p < 0.001) and 5% (p < 0.001) respectively, with no differences between exams (p > 0.05). Conclusion: Amyloid-PET and tau-PET significantly impacted diagnosis and diagnostic confidence in a similar way, although a negative amyloid-PET has a stronger impact on diagnosis than a negative tau-PET. Adding either of the two as second exam further improved diagnostic confidence. Trial number: PB 2016-01346.
2021
7
Altomare, Daniele; Caprioglio, Camilla; Assal, Frédéric; Allali, Gilles; Mendes, Aline; Ribaldi, Federica; Ceyzeriat, Kelly; Martins, Marta; Tomczyk, ...espandi
Diagnostic value of amyloid-PET and tau-PET: a head-to-head comparison / Altomare, Daniele; Caprioglio, Camilla; Assal, Frédéric; Allali, Gilles; Mendes, Aline; Ribaldi, Federica; Ceyzeriat, Kelly; Martins, Marta; Tomczyk, Szymon; Stampacchia, Sara; Dodich, Alessandra; Boccardi, Marina; Chicherio, Christian; Frisoni, Giovanni B.; Garibotto, Valentina. - In: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - ISSN 1619-7070. - 48:7(2021), pp. 2200-2211. [10.1007/s00259-021-05246-x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11572/320656
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