Defining imaging biomarker cut points for brain aging and Alzheimer's disease

Clifford R Jr. Jack, Heather J. Wiste, Stephen D. Weigand, Terry M Therneau, Val Lowe, David S Knopman, Jeffrey L. Gunter, Matthew L. Senjem, David T Jones, Kejal M Kantarci, Mary Margaret Machulda, Michelle M Mielke, Rosebud O Roberts, Prashanthi D Vemuri, Denise A. Reyes, Ronald Carl Petersen

Research output: Contribution to journalArticle

121 Scopus citations

Abstract

Introduction: Our goal was to develop cut points for amyloid positron emission tomography (PET), tau PET, flouro-deoxyglucose (FDG) PET, and MRI cortical thickness. Methods: We examined five methods for determining cut points. Results: The reliable worsening method produced a cut point only for amyloid PET. The specificity, sensitivity, and accuracy of cognitively impaired versus young clinically normal (CN) methods labeled the most people abnormal and all gave similar cut points for tau PET, FDG PET, and cortical thickness. Cut points defined using the accuracy of cognitively impaired versus age-matched CN method labeled fewer people abnormal. Discussion: In the future, we will use a single cut point for amyloid PET (standardized uptake value ratio, 1.42; centiloid, 19) based on the reliable worsening cut point method. We will base lenient cut points for tau PET, FDG PET, and cortical thickness on the accuracy of cognitively impaired versus young CN method and base conservative cut points on the accuracy of cognitively impaired versus age-matched CN method.

Original languageEnglish (US)
JournalAlzheimer's and Dementia
DOIs
StateAccepted/In press - 2016

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Keywords

  • Alzheimer's biomarkers
  • Alzheimer's disease
  • Alzheimer's imaging
  • Alzheimer's MRI
  • Amyloid PET
  • FDG PET
  • Quantitative imaging
  • Tau PET

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Geriatrics and Gerontology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health

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