• Pierpaolo Alongi, Davide Stefano Sardina, Rosalia Coppola, Salvatore Scalisi, Valentina Puglisi, Annachiara Arnone, Raimondo Giorgio Di GD U.O.C. Neurologia, Fondazione IstitutoG. Giglio, Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, Italy., Elisabetta Munerati, Valerio Alaimo, Federico Midiri, Giorgio Russo, Alessandro Stefano, Rosalba Giugno, Tommaso Piccoli, Massimo Midiri, and Grimaldi Luigi M E LME U.O.C. Neurologia, Fondazione IstitutoG. Giglio, Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, Italy..
• Department of Radiological Sciences, Nuclear Medicine Service, Fondazione Istituto G. Giglio, Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, Italy.
• J Neuroimaging. 2019 May 1; 29 (3): 383-393.

Background And PurposeWhile AD can be definitively confirmed by postmortem histopathologic examination, in vivo imaging may improve the clinician's ability to identify AD at the earliest stage. The aim of the study was to test the performance of amyloid PET using new processing imaging algorithm for more precise diagnosis of AD.MethodsAmyloid PET results using a new processing imaging algorithm (MRI-Less and AAL Atlas) were correlated with clinical, cognitive status, CSF analysis, and other imaging. The regional SUVR using the white matter of cerebellum as reference region and scores from clinical and cognitive tests were used to create ROC curves. Leave-one-out cross-validation was carried out to validate the results.ResultsForty-four consecutive patients with clinical evidence of dementia, were retrospectively evaluated. Amyloid PET scan was positive in 26/44 patients with dementia. After integration with 18F-FDG PET, clinical data and CSF protein levels, 22 of them were classified as AD, the remaining 4 as vascular or frontotemporal dementia. Amyloid and FDG PET, CDR 1, CSF Tau, and p-tau levels showed the best true positive and true negative rates (amyloid PET: AUC = .85, sensitivity .91, specificity .79). A SUVR value of 1.006 in the inferior frontal cortex and of 1.03 in the precuneus region was the best cutoff SUVR value and showed a good correlation with the diagnosis of AD. Thirteen of 44 amyloid PET positive patients have been enrolled in clinical trials using antiamyloid approaches.ConclusionsAmyloid PET using SPM-normalized SUVR analysis showed high predictive power for the differential diagnosis of AD.© 2019 by the American Society of Neuroimaging.

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