title: Neuropathologic heterogeneity does not impair florbetapir-positron emission tomography postmortem correlates.
abstract: Neuropathologic heterogeneity is often present among Alzheimer disease (AD) patients. We sought to determine whether amyloid imaging measures of AD are affected by concurrent pathologies. Thirty-eight clinically and pathologically defined AD and 17 nondemented patients with quantitative florbetapir F-18 (F-AV-45) positron emission tomography (PET) imaging during life and postmortem histological β-amyloid quantification and neuropathologic examination were assessed. AD patients were divided on the basis of concurrent pathologies, including those with Lewy bodies (LBs) (n = 21), white matter rarefaction (n = 27), severe cerebral amyloid angiopathy (n = 11), argyrophilic grains (n = 5), and TAR DNA binding protein-43 inclusions (n = 18). Many patients exhibited more than 1 type of concurrent pathology. The ratio of cortical to cerebellar amyloid imaging signal (SUVr) and immunohistochemical β-amyloid load were analyzed in 6 cortical regions of interest. All AD subgroups had strong and significant correlations between SUVr and histological β-amyloid measures (p μ 0.001). All AD subgroups had significantly greater amyloid measures versus nondemented patients, and mean amyloid measures did not significantly differ between AD subgroups. When comparing AD cases with and without each pathology, AD cases with LBs had significantly lower SUVr measures versus AD cases without LBs (p = 0.002); there were no other paired comparison differences. These findings indicate that florbetapir-PET imaging is not confounded by neuropathological heterogeneity within AD.
authors: From the Avid Radiopharmaceuticals (CMC, ML, APC, ADJ, MAM, MJP, DMS), Philadelphia, Pennsylvania; Banner Sun Health Research Institute (BND, GS, MM, MNS, LIS, TGB), Sun City, Arizona; Biospective Inc. and Montreal Neurological Institute (BJB, SPZ), McGill University, Montreal, Canada; Duke University Medical Center (REC, PMD), Durham, North Carolina; Banner Alzheimer's Institute (ASF, EMR), Phoenix, Arizona; Nova SE University (CHS), Ft Lauderdale, Florida; and Rush University Medical Center (JAS), Chicago, Illinois.
authors: Brittany N
authors: BN
authors: Dugger
authors: Christopher M
authors: CM
authors: Clark
authors: Geidy
authors: G
authors: Serrano
authors: Monica
authors: M
authors: Mariner
authors: Barry J
authors: BJ
authors: Bedell
authors: R Edward
authors: RE
authors: Coleman
authors: P Murali
authors: PM
authors: Doraiswamy
authors: Ming
authors: M
authors: Lu
authors: Adam S
authors: AS
authors: Fleisher
authors: Eric M
authors: EM
authors: Reiman
authors: Marwan N
authors: MN
authors: Sabbagh
authors: Carl H
authors: CH
authors: Sadowsky
authors: Julie A
authors: JA
authors: Schneider
authors: Simone P
authors: SP
authors: Zehntner
authors: Alan P
authors: AP
authors: Carpenter
authors: Abhinay D
authors: AD
authors: Joshi
authors: Mark A
authors: MA
authors: Mintun
authors: Michael J
authors: MJ
authors: Pontecorvo
authors: Daniel M
authors: DM
authors: Skovronsky
authors: Lucia I
authors: LI
authors: Sue
authors: Thomas G
authors: TG
authors: Beach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D000814:Aniline Compounds; D005026:Ethylene Glycols; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards
chemical_list: D000814:Aniline Compounds; D005026:Ethylene Glycols; D005462:Fluorine Radioisotopes; C545186:florbetapir