Clinical validity of increased cortical uptake of amyloid ligands on PET as a biomarker for Alzheimer's disease in the context of a structured 5-phase development framework

Konstantinos Chiotis, Laure Saint-Aubert, Marina Boccardi, Anton Gietl, Agnese Picco, Andrea Varrone, Valentina Garibotto, Karl Herholz, Flavio Nobili, Agneta Nordberg, Giovanni B. Frisoni, Bengt Winblad, Clifford R. Jack

Research output: Contribution to journalReview article

34 Scopus citations

Abstract

The use of biomarkers has been proposed for diagnosing Alzheimer's disease in recent criteria, but some biomarkers have not been sufficiently investigated to justify their routine clinical use. Here, we evaluate in a literature review the clinical validity of amyloid positron emission tomography (PET) imaging using a structured framework developed for the assessment of oncological biomarkers. Homogenous criteria have been addressed in reviews of other Alzheimer's disease biomarkers. There is adequate evidence that the main aims of phases 1 (rationale for use) and 2 (discriminative ability) have been achieved. The aims of phase 3 (early detection ability) have been partly achieved, while phase 4 studies (performance in representative mild cognitive impairment patients) are currently ongoing. Phase 5 studies (quantification of impact and costs) are still to come. This review highlights the priorities to be pursued to enable the proper use of amyloid PET imaging in a clinical setting. Future investigations will primarily be large, phase 4 studies that will assess the utility of amyloid PET imaging in routine clinical practice.

Original languageEnglish (US)
Pages (from-to)214-227
Number of pages14
JournalNeurobiology of aging
Volume52
DOIs
StatePublished - Apr 1 2017

Keywords

  • 5-Phases
  • Alzheimer's disease
  • Amyloid
  • Biomarker
  • Biomarker-based diagnosis
  • Clinical validity
  • Development
  • Early diagnosis
  • Neuroimaging
  • Positron emission tomography

ASJC Scopus subject areas

  • Neuroscience(all)
  • Aging
  • Clinical Neurology
  • Developmental Biology
  • Geriatrics and Gerontology

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    Chiotis, K., Saint-Aubert, L., Boccardi, M., Gietl, A., Picco, A., Varrone, A., Garibotto, V., Herholz, K., Nobili, F., Nordberg, A., Frisoni, G. B., Winblad, B., & Jack, C. R. (2017). Clinical validity of increased cortical uptake of amyloid ligands on PET as a biomarker for Alzheimer's disease in the context of a structured 5-phase development framework. Neurobiology of aging, 52, 214-227. https://doi.org/10.1016/j.neurobiolaging.2016.07.012