Clinical validity of medial temporal atrophy as a biomarker for Alzheimer's disease in the context of a structured 5-phase development framework.
Research criteria for Alzheimer's disease recommend the use of biomarkers for diagnosis, but whether biomarkers improve the diagnosis in clinical routine has not been systematically assessed. The aim is to evaluate the evidence for use of medial temporal lobe atrophy (MTA) as a biomarker for Alzheimer's disease at the mild cognitive impairment stage in routine clinical practice, with an adapted version of the 5-phase oncology framework for biomarker development. A literature review on visual assessment of MTA and hippocampal volumetry was conducted with other biomarkers addressed in parallel reviews. Ample evidence is available for phase 1 (rationale for use) and phase 2 (discriminative ability between diseased and control subjects). Phase 3 (early detection ability) is partly achieved: most evidence is derived from research cohorts or clinical populations with short follow-up, but validation in clinical mild cognitive impairment cohorts is required. In phase 4, only the practical feasibility has been addressed for visual rating of MTA. The rest of phase 4 and phase 5 have not yet been addressed.
Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands. Electronic address: m.tenkate1@vumc.nl.
Mara
M
Ten Kate
Department of Radiology & Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; European Society of Neuroradiology (ESNR); Institutes of Neurology and Healthcare Engineering, University College London, London, UK.
Frederik
F
Barkhof
Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), IRCCS S.Giovanni di Dio - Fatebenefratelli, Brescia, Italy; LANVIE (Laboratory of Neuroimaging of Aging) - Department of Psychiatry, University of Geneva, Geneva, Switzerland.
Marina
M
Boccardi
Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
Pieter Jelle
PJ
Visser
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Clifford R
CR
Jack
Department of Neuroradiology, University Hospital of Geneva, Geneva, Switzerland.
Karl-Olof
KO
Lovblad
Institutes of Neurology and Healthcare Engineering, University College London, London, UK; Memory Clinic - Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland.
Giovanni B
GB
Frisoni
Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
Philip
P
Scheltens
D000544:Alzheimer Disease / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D001284:Atrophy; D015415:Biomarkers; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D015331:Cohort Studies; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D015203:Reproducibility of Results; D013702:Temporal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D015415:Biomarkers
Alzheimer's disease; Dementia; Hippocampus; MRI; Medial temporal lobe atrophy; Mild cognitive impairment; Roadmap