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Modified RCTU Score: A Semi-Quantitative, Visual Tool for Predicting Alzheimer's Conversion from aMCI.

Ari Chong1, Jung-Min Ha1, Ji Yeon Chung2

  • 1Department of Nuclear Medicine, School of Medicine, Chosun University/Chosun University Hospital, Gwangju 61452, Republic of Korea.

Brain Sciences
|February 23, 2024
PubMed
Summary

A modified amyloid PET scan score effectively predicts Alzheimer's Disease progression in mild cognitive impairment. Symmetric amyloid deposits identified by this score indicate a higher risk for conversion to Alzheimer's Disease.

Keywords:
Alzheimer’s diseaseRCTUamyloid burdenmild cognitive impairmentpositron emission tomography

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Area of Science:

  • Neurology
  • Nuclear Medicine
  • Neuroimaging

Background:

  • Mild Cognitive Impairment (MCI) is a prodromal stage for Alzheimer's Disease (AD).
  • Early prediction of AD conversion from MCI is crucial for timely intervention.
  • Amyloid Positron Emission Tomography (PET) is a key biomarker for AD pathology.

Purpose of the Study:

  • To evaluate a modified Regional Cerebrospinal Tau Uptake (RCTU) score derived from amyloid PET scans.
  • To assess the modified RCTU score's ability to predict the progression from amnestic MCI (aMCI) to AD.
  • To compare the modified RCTU score with the conventional RCTU score and amyloid Standardized Uptake Value Ratio (SUVR).

Main Methods:

  • Retrospective analysis of 45 aMCI patients with baseline amyloid PET scans.
  • Modification of the RCTU score by segmenting cerebral lobes into seven distinct regions.
  • Correlation analysis between modified RCTU scores, conventional RCTU scores, and amyloid SUVR.
  • Neuropsychological testing to identify conversion to AD during follow-up.

Main Results:

  • 12 out of 45 patients progressed to AD over 17.8 ± 6.8 months.
  • AD converters exhibited significantly higher modified RCTU scores compared to non-converters.
  • The modified RCTU score demonstrated a strong correlation with amyloid SUVR (r > 0.7).
  • Symmetric amyloid deposition, identified by the modified RCTU, was associated with a higher risk of AD conversion.

Conclusions:

  • The modified RCTU score is a promising tool for predicting AD conversion in aMCI patients.
  • The modified RCTU score accurately reflects amyloid burden and its distribution, including asymmetry.
  • Symmetric amyloid deposition patterns identified by the modified RCTU score are indicative of increased AD progression risk.