Histopathology and Florbetaben PET in Patients Incorrectly Diagnosed with Alzheimer’s Disease

Article type: Short Communication

Authors: Sabbagh, Marwan N.^{a; *} | Schäuble, Barbara^b | Anand, Keshav^a | Richards, Danielle^c | Murayama, Shigeo^{d; e} | Akatsu, Hiroyasu^{f; g} | Takao, Masaki^{e; h} | Rowe, Christopher C.ⁱ | Masters, Colin L.^j | Barthel, Henryk^k | Gertz, Hermann-Josef^l | Peters, Oliver^m | Rasgon, Natalieⁿ | Jovalekic, Aleksandar^o | Sabri, Osama^{k; 2} | Schulz-Schaeffer, Walter J.^{p; 1; 2} | Seibyl, John^{q; 2}

Affiliations: [a] Alzheimer’s and Memory Disorders Division, Barrow Neurological Institute, Phoenix, AZ, USA | [b] Formerly Piramal Imaging GmbH, Berlin, Germany | [c] Banner Sun Health Research Institute, Sun City, AZ, USA | [d] Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan | [e] Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan | [f] Fukushimura Hospital, Toyohashi, Japan | [g] Departments of Community-based Medicine and Neurology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan | [h] Mihara Memorial Hospital, Isesaki, Japan | [i] Austin Health, University of Melbourne, Melbourne, VIC, Australia | [j] The Florey Institute, The University of Melbourne, Australia | [k] Department of Nuclear Medicine, Leipzig University, Leipzig, Germany | [l] Department of Psychiatry, Leipzig University, Leipzig, Germany | [m] Department of Psychiatry and Psychotherapy, Charité Berlin, Berlin, Germany | [n] Department of Psychiatry, Stanford School of Medicine, Stanford, USA | [o] Piramal Imaging GmbH, Berlin, Germany | [p] Georg-August University Göttingen, Göttingen, Germany | [q] Molecular Neuroimaging, New Haven, CT, USA

Correspondence: [*] Correspondence to: Dr. Marwan N. Sabbagh, Alzheimer’s and Memory Disorders Division, Department of Neurology, Barrow Neurological Institute, 240 W. Thomas Rd, Ste 301, Phoenix, AZ 85013, USA. E-mail: Marwan.Sabbagh@DignityHealth.org.

Note: [1] Present address: Saarland University Medical Center, Homburg, Germany

Note: [2] These authors contributed equally to this work.

Abstract: Of 57 individuals diagnosed with Alzheimer’s disease (AD) in a phase III study, 13 (23%) had amyloid-β (Aβ) levels on postmortem histopathology that did not explain the dementia. Based on postmortem histopathology, a wide range of different non-AD conditions was identified, including frontotemporal dementia, hippocampal sclerosis, and dementia with Lewy bodies. Of the histopathologically Aβ negative scored cases ante-mortem Florbetaben PET scans were classified as negative for Aβ in 11 patients based on visual analysis and in all 12 quantifiable cases based on composite standardized uptake value ratios. Thus, florbetaben PET can assist physicians in the differential diagnosis of neurodegenerative disorders by reliably excluding Aβ pathology.

Keywords: Alzheimer’s disease, florbetaben PET, histopathology

DOI: 10.3233/JAD-160821

Journal: Journal of Alzheimer's Disease, vol. 56, no. 2, pp. 441-446, 2017