. PIB versus FDG PET in pathologically verified dementia. Human Amyloid Imaging 2011 Meeting Abstracts. 2011 Jan 15;

Abstract:

Objective: To compare PIB and FDG PET to histopathology in a heterogeneous dementia population. Design/

Methods: Thirteen dementia patients (mean age 67.8}10.0, MMSE 19.3}7.5) underwent [11C]PIB and [18F]FDG PET. Clinical diagnoses included Alzheimer's disease (AD, N = 3) and the frontotemporal lobar degeneration (FTLD) syndromes frontotemporal dementia (N = 4), semantic dementia (N = 3) and corticobasal syndrome (CBS, N = 3). PIB DVR images (cerebellar reference) were visually rated by two investigators blinded to clinical diagnosis as PIB-positive or negative. FDG scans (pons-normalized) were visually rated as consistent with AD or FTLD. Histopathology was determined by autopsy (N = 11, 2.3)1.4 years after PET), biopsy (N = 1) or presence of a pathogenic mutation (N = 1).

Results: Pathologic diagnoses included high-likelihood AD (N = 3), mixed AD/dementia with Lewy bodies (AD/ DLB, N = 1), FTLD-TDP (N = 5), Pickfs disease (N = 2) and corticobasal degeneration (CBD, N = 2). PIB Index (mean DVR in frontal, parietal, lateral temporal and cingulate cortex) was higher in patients with AD pathology (1.43}0.38) than in pathologically-confirmed FTLD (1.01}0.08, p Conclusions: Visual reads of PIB outperformed FDG in predicting histopathology in this small series. PIB visual reads did not detect early amyloid pathology co-morbid with FTLD, which in this case enhanced specificity for primary AD. Amyloid PET is likely to improve in vivo prediction of histopathology in dementia. Acknowledgements: NIA K23-AG031861, R01-AG027859, P01-AG1972403, P50-AG023501, Alzheimer's Association NIRG-07-59422, John Douglas French Alzheimer's Foundation.

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