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Comparing 18F-AV-1451 with CSF t-tau and p-tau for diagnosis of Alzheimer disease
Mattsson N, Smith R, Strandberg O, Palmqvist S, Schöll M, Insel PS, Hägerström D, Ohlsson T et al.. Neurology, 2018-01-10
Topic: Amyloid, tau and blood-test diagnosis
Objective To compare PET imaging of tau pathology with CSF measurements (total tau [t-tau] and phosphorylated tau [p-tau]) in terms of diagnostic performance for Alzheimer disease (AD). Methods We compared t-tau and p-tau and 18 F-AV-1451 in 30 controls, 14 patients with prodromal AD, and 39 patients with Alzheimer dementia, recruited from the Swedish BioFINDER study. All patients with AD (prodromal and dementia) were screened for amyloid positivity using CSF β-amyloid 42. Retention of 18 F-AV-1451 was measured in a priori specified regions, selected for known associations with tau pathology in AD. Results Retention of 18 F-AV-1451 was markedly elevated in Alzheimer dementia and moderately elevated in prodromal AD. CSF t-tau and p-tau was increased to similar levels in both AD dementia and prodromal AD. 18 F-AV-1451 had very good diagnostic performance for Alzheimer dementia (area under the receiver operating characteristic curve [AUROC] ∼1.000), and was significantly better than t-tau (0.876), p-tau (0.890), hippocampal volume (0.824), and temporal cortical thickness (0.860). For prodromal AD, there were no significant AUROC differences between CSF tau and 18 F-AV-1451 measures (0.836-0.939), but MRI measures had lower AUROCs (0.652-0.769). Conclusions CSF tau and 18 F-AV-1451 have equal performance in early clinical stages of AD, but 18 F-AV-1451 is superior in the dementia stage, and exhibits close to perfect diagnostic performance for mild to moderate AD. Classification of evidence This study provides Class III evidence that CSF tau and 18 F-AV-1451 PET have similar performance in identifying early AD, and that 18 F-AV-1451 PET is superior to CSF tau in identifying mild to moderate AD.
Key findings
- Results Retention of 18 F-AV-1451 was markedly elevated in Alzheimer dementia and moderately elevated in prodromal AD.
- CSF t-tau and p-tau was increased to similar levels in both AD dementia and prodromal AD. 18 F-AV-1451 had very good diagnostic performance for Alzheimer dementia (area under the receiver operating characteristic curve [AUROC] ∼1.000), and was significantly better than t-tau (0.876), p-tau (0.890), hippocampal volume (0.824), and temporal cortical thickness (0.860).
- For prodromal AD, there were no significant AUROC differences between CSF tau and 18 F-AV-1451 measures (0.836-0.939), but MRI measures had lower AUROCs (0.652-0.769).
Why it matters
Comparing tau PET with CSF tau measures in 83 participants, 18F-AV-1451 performed very well for Alzheimer dementia and better than CSF t-tau, p-tau and MRI measures, while in prodromal AD there were no significant differences between CSF tau and the PET measure. These are diagnostic comparisons only and do not indicate any way to treat, cure or prevent the disease.
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Study details
- Participants14
- Evidence strengthLow
How this study scored 56/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 1 / 4 | 14 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 96 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.6 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 4 / 6 | Cited 11.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 1 / 4 | Cited 10 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Oskar Hansson: h-index 148 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 9 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29321235) |
| Free to read | 2 / 2 | Free to read |
| Total | 56 / 100 | — |
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Read the original
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Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Mattsson, N., Smith, R., Strandberg, O., Palmqvist, S., Schöll, M., Insel, P. S., et al. (2018). Comparing 18F-AV-1451 with CSF t-tau and p-tau for diagnosis of Alzheimer disease. Neurology. https://doi.org/10.1212/wnl.0000000000004887
Vancouver
Mattsson N, Smith R, Strandberg O, Palmqvist S, Schöll M, Insel PS, et al. Comparing 18F-AV-1451 with CSF t-tau and p-tau for diagnosis of Alzheimer disease. Neurology. 2018. doi:10.1212/wnl.0000000000004887. PMID: 29321235.
BibTeX
@article{mattsson2018-29321235,
author = {Mattsson, N. and Smith, R. and Strandberg, O. and Palmqvist, S. and Schöll, M. and Insel, P. S. and Hägerström, D. and Ohlsson, T. and others},
title = {{Comparing 18F-AV-1451 with CSF t-tau and p-tau for diagnosis of Alzheimer disease}},
journal = {Neurology},
year = {2018},
doi = {10.1212/wnl.0000000000004887},
pmid = {29321235},
url = {https://doi.org/10.1212/wnl.0000000000004887}
}
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