title: Diagnostic utility of amyloid PET in cerebral amyloid angiopathy-related symptomatic intracerebral hemorrhage.
abstract: By detecting β-amyloid (Aβ) in the wall of cortical arterioles, amyloid positron emission tomography (PET) imaging might help diagnose cerebral amyloid angiopathy (CAA) in patients with lobar intracerebral hemorrhage (l-ICH). No previous study has directly assessed the diagnostic value of (11)C-Pittsburgh compound B (PiB) PET in probable CAA-related l-ICH against healthy controls (HCs). (11)C-PiB-PET and magnetic resonance imaging (MRI) including T2* were obtained in 11 nondemented patients fulfilling the Boston criteria for probable CAA-related symptomatic l-ICH (sl-ICH) and 20 HCs without cognitive complaints or impairment. After optimal spatial normalization, cerebral spinal fluid (CSF)-corrected PiB distribution volume ratios (DVRs) were obtained. There was no significant difference in whole cortex or regional DVRs between CAA patients and age-matched HCs. The whole cortex DVR was above the 95% confidence limit in 4/9 HCs and 10/11 CAA patients (sensitivity=91%, specificity=55%). Region/frontal or occipital ratios did not have better discriminative value. Similar but less accurate results were found using visual analysis. In patients with sl-ICH, (11)C-PiB-PET has low specificity for CAA due to the frequent occurrence of high (11)C-PiB uptake in the healthy elderly reflecting incipient Alzheimer's disease (AD), which might also be present in suspected CAA. However, a negative PiB scan rules out CAA with excellent sensitivity, which has clinical implications for prognostication and selection of candidates for drug trials.
authors.affiliation: 1] Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK [2] INSERM U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Baron
authors.affiliation: APHP, Hotel-Dieu Hospital, Department of Nuclear Medicine, Paris, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Farid
authors.affiliation: Stroke Unit, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Eamon
authors.initials: E
authors.lastname: Dolan
authors.affiliation: INSERM U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Turc
authors.affiliation: Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: Siva T
authors.initials: ST
authors.lastname: Marrapu
authors.affiliation: Stroke Unit, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Eoin
authors.initials: E
authors.lastname: O'Brien
authors.affiliation: Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK.
authors.forename: Franklin I
authors.initials: FI
authors.lastname: Aigbirhio
authors.affiliation: Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK.
authors.forename: Tim D
authors.initials: TD
authors.lastname: Fryer
authors.affiliation: Division of Anaesthesia, University of Cambridge, Cambridge, UK.
authors.forename: David K
authors.initials: DK
authors.lastname: Menon
authors.affiliation: Stroke Unit, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Warburton
authors.affiliation: Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK.
authors.forename: Young T
authors.initials: YT
authors.lastname: Hong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000814:Aniline Compounds; D001921:Brain / Q000098:blood supply* / Q000473:pathology*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D013844:Thiazoles
chemical_list: C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D000814:Aniline Compounds; D013844:Thiazoles