Defining imaging biomarker cut points for brain aging and Alzheimer's disease

• Published in: Alzheimer's & dementia Vol. 13; no. 3; pp. 205 - 216
• Main Authors: Jack, Clifford R, Wiste, Heather J, Weigand, Stephen D, Therneau, Terry M, Lowe, Val J, Knopman, David S, Gunter, Jeffrey L, Senjem, Matthew L, Jones, David T, Kantarci, Kejal, Machulda, Mary M, Mielke, Michelle M, Roberts, Rosebud O, Vemuri, Prashanthi, Reyes, Denise A, Petersen, Ronald C
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2017
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Aging - pathology; Alzheimer Disease - diagnostic imaging; Alzheimer's biomarkers; Alzheimer's disease; Alzheimer's imaging; Alzheimer's MRI; Amyloid PET; Amyloidosis; Aniline Compounds - metabolism; Brain - diagnostic imaging; Brain - pathology; FDG PET; Female; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neurology; Positron-Emission Tomography; Quantitative imaging; Sensitivity and Specificity; Tau PET; Thiazoles - metabolism; Alzheimer's MRI; Amyloid PET; Tau PET; Alzheimer's biomarkers; Quantitative imaging; Alzheimer's imaging; Alzheimer's disease; FDG PET
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1016/j.jalz.2016.08.005

Abstract Introduction Our goal was to develop cut points for amyloid positron emission tomography (PET), tau PET, flouro-deoxyglucose (FDG) PET, and MRI cortical thickness. Methods We examined five methods for determining cut points. Results The reliable worsening method produced a cut point only for amyloid PET. The specificity, sensitivity, and accuracy of cognitively impaired versus young clinically normal (CN) methods labeled the most people abnormal and all gave similar cut points for tau PET, FDG PET, and cortical thickness. Cut points defined using the accuracy of cognitively impaired versus age-matched CN method labeled fewer people abnormal. Discussion In the future, we will use a single cut point for amyloid PET (standardized uptake value ratio, 1.42; centiloid, 19) based on the reliable worsening cut point method. We will base lenient cut points for tau PET, FDG PET, and cortical thickness on the accuracy of cognitively impaired versus young CN method and base conservative cut points on the accuracy of cognitively impaired versus age-matched CN method.