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@ARTICLE{Eckenweber:285360,
author = {Eckenweber, Sebastian and Völter, Friederike and
Franzmeier, Nicolai and Palleis, Carla and Wagemann, Olivia
and Weidinger, Endy and Katzdobler, Sabrina and Wlasich,
Elisabeth and Sandkühler, Katja and Böning, Guido and
Gnoerich, Johannes and Scheifele, Maximilian and Eckenweber,
Florian and Janowitz, Daniel and Kurz, Carolin and
Perneczky, Robert and Bürger, Katharina and Danek, Adrian
and Höglinger, Günter and Levin, Johannes and Brendel,
Matthias and Schönecker, Sonja},
title = {{A}dditive value of early-phase β-{A}myloid-{PET} for the
differential diagnosis of non-{A}lzheimer's disease
dementia.},
journal = {NeuroImage: Clinical},
volume = {49},
issn = {2213-1582},
address = {[Amsterdam u.a.]},
publisher = {Elsevier},
reportid = {DZNE-2026-00225},
pages = {103963},
year = {2026},
abstract = {Recent studies demonstrated strong agreement between
early-phase β-amyloid-PET perfusion imaging and glucose
hypometabolism assessed by [18F]FDG-PET, indicating the
potential of early-phase β-amyloid-PET as a surrogate
biomarker of neuronal injury. We therefore aimed to
investigate the additive value of early-phase β-amyloid-PET
for the differential diagnosis of non-Alzheimer's disease
dementia syndromes in clinical routine.[18F]florbetaben- and
[18F]flutemetamol-PET scans (n = 379) performed between July
2013 and July 2021 were analyzed for their amyloid status
and the presence of a neurodegenerative hypoperfusion
pattern using visual assessment and z-score maps. In
patients visually rated as
amyloid-negative/neurodegeneration-positive (A-N+), the most
likely diagnosis based on perfusion patterns was compared to
the final clinical diagnosis, i.e. frontotemporal dementia
or psychiatric disorders, suspected 4R-tauopathy, and
suspected non-Alzheimer pathophysiology. Logistic regression
models based on a data-driven selection of cerebral regions
of hypoperfusion by principal component analysis were used
to predict neurodegenerative disease and clinical diagnoses.
Diagnostic accuracy was compared between visual assessment
and the regression models.Neurodegeneration status was
correctly identified in $78.8\%$ (119/151) of
amyloid-negative patients through visual rating, compared to
$67.5\%$ (102/151) using logistic regression. Visual
assessment assigned $75.3\%$ (67/89) of A-N+ patients to the
correct diagnostic category. In contrast, the regression
model classified $69.7\%$ (62/89) of patients.The current
study demonstrates an additive value of early-phase
β-amyloid-PET for the differential diagnosis of dementia
syndromes. While visual assessment of early-phase
β-amyloid-PET already provides substantial diagnostic
accuracy, a data-driven analysis approach could aid in cases
of uncertainty.},
keywords = {4-repeattauopathy (Other) / Data driven (Other) /
Early-phaseβ-amyloid-PET (Other) / Frontotemporal dementia
(Other) / Multinomial logistic regression (Other) /
Suspected non-Alzheimer pathophysiology (Other)},
cin = {Clinical Research (Munich) / AG Dichgans / AG Levin / AG
Haass},
ddc = {610},
cid = {I:(DE-2719)1111015 / I:(DE-2719)5000022 /
I:(DE-2719)1111016 / I:(DE-2719)1110007},
pnm = {353 - Clinical and Health Care Research (POF4-353) / 352 -
Disease Mechanisms (POF4-352)},
pid = {G:(DE-HGF)POF4-353 / G:(DE-HGF)POF4-352},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41690259},
pmc = {pmc:PMC12925280},
doi = {10.1016/j.nicl.2026.103963},
url = {https://pub.dzne.de/record/285360},
}