La TEP des plaques amyloïdes: Son potentiel diagnostique par rapport au FDG

Amyloid PET using high-affinity ligands for fibrillary amyloid is providing high specificity and sensitivity for detection of Alzheimer's disease (AD) even before onset of dementia. Most current published data have been acquired using 11C-Pittsburgh Compound B (PIB). However, due to the extremely short half-life of 11C, PIB is available only in some research laboratories. This limitation will be overcome by 18F-labeled ligands which are currently undergoing formal clinical trials as amyloid imaging agents and are expected to become commercially available for clinical use in the near future. Compared to FDG, which demonstrates regional metabolic deficits in AD and late-stage mild cognitive impairment (MCI), amyloid imaging is expected to provide higher sensitivity for early detection of AD. By detecting amyloid, it is providing information that is complementary to clinical symptoms, while FDG-PET is more closely related to dementia severity and cognitive symptoms. Current data suggest that a negative amyloid PET scan is likely to rule out AD with more than 90% certainty, while a positive scan in a dementia patient or a patient with amnestic MCI indicates a very high likelihood of AD. There is still uncertainty about the clinical significance of positive amyloid scans in elderly normal controls (10 to 40% depending on age and selection criteria). © 2011 Elsevier Masson SAS.