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Consorcio de Imagenología de Alzheimer

Andreia Rocha1, Bruna Bellaver1, Emma Ruppert1

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Resumen
Este resumen es generado por máquina.

La armonización de la estadificación de tau PET para la enfermedad de Alzheimer (EA) utilizando MK6240 y Flortaucipir muestra discrepancias. Los ajustes en los puntos de corte y las regiones de interés mejoran la concordancia, especialmente con un sistema simplificado de estadificación de Braak de 4 clases.

Palabras clave:
PET tauEnfermedad de AlzheimerEstadificación de BraakMK6240FlortaucipirArmonizaciónNeuroimagenología

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Área de la Ciencia:

  • Neuroimagenología
  • Investigación de la Enfermedad de Alzheimer
  • Desarrollo de Biomarcadores

Sus antecedentes:

  • La estadificación de Braak in vivo estratifica a los pacientes del espectro de la enfermedad de Alzheimer (EA).
  • La armonización de la estadificación con trazadores de PET tau es crucial para una evaluación consistente de la EA.
  • Este estudio compara los procedimientos de armonización para la estadificación de Braak utilizando los trazadores de PET tau MK6240 y Flortaucipir.

Objetivo del estudio:

  • Comparar y probar procedimientos de armonización para la estadificación de Braak utilizando los trazadores de PET tau MK6240 y Flortaucipir.
  • Evaluar diferentes métodos de corte y categorías de estadificación para optimizar la concordancia.
  • Evaluar el acuerdo inter e intra-trazador en la estadificación de la enfermedad de Alzheimer.

Principales métodos:

  • Se evaluaron 437 participantes (245 sin deterioro cognitivo, 192 con deterioro) utilizando escáneres MK6240 y Flortaucipir cabeza a cabeza.
  • Se calcularon las relaciones de valor de absorción estandarizado (SUVR) en las regiones de interés (ROI) de Braak.
  • Se evaluaron cuatro métodos de corte (SD, GMM, índice de Youden) y dos categorías de estadificación (7 clases vs. 4 clases) para la estadificación de Braak.

Principales resultados:

  • La concordancia de la estadificación de Braak intra-trazador varió del 63% al 94%, con puntos de corte de modelado de mezcla gaussiana (GMM) que arrojaron los más altos (94% para MK6240, 89% para Flortaucipir).
  • El acuerdo inter-trazador varió del 56% al 76%, con el punto de corte CU Elderly Aβ- que mostró la mayor concordancia.
  • Una estadificación de Braak simplificada de 4 clases mejoró la concordancia intra-trazador y el acuerdo inter-trazador (86,5%), con la mayoría de las discrepancias en las etapas II-IV.

Conclusiones:

  • Los hallazgos preliminares muestran discrepancias en la estadificación de Braak entre los trazadores MK6240 y Flortaucipir.
  • Los ajustes en los puntos de corte y las ROI pueden mitigar parcialmente las divergencias inter e intra-trazador.
  • Se puede lograr una concordancia robusta con puntos de corte ajustados y un sistema de estadificación de 4 clases (0, I-II, III-IV, V-VI).