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Prospective flutemetamol positron emission tomography and histopathology in normal pressure hydrocephalus


Rinne, Juha O., Frantzen, Janek, Leinonen, Ville, Lonnrot, Kimmo, Laakso, Aki, Virtanen, Kirsi A., Solin, Olof, Kotkansalo, Anna, Koivisto, Anne, Sajanti, Juha, Karppinen, Atte, Lehto, Hanna, Rummukainen, Jaana, Buckley, Chris, Smith, Adrian, Jones, Paul A., Sherwin, Paul, Farrar, Gill, McLain, Richard, Kailajarvi, Marita, Grachev, Igor D.


Neuro-Degenerative Diseases, Volume: 13, No.: 4, Pages.: 237-245

Year of Publication



Unlabelled: BACKGOUND/OBJECTIVE: To determine the level of association between uptake of the amyloid positron emission tomography (PET) imaging agent [(18)F]flutemetamol and the level of amyloid-β measured by immunohistochemical and histochemical staining in a frontal cortical region biopsy site.; Methods: Seventeen patients with probable normal pressure hydrocephalus (NPH) underwent prospective [(18)F]flutemetamol PET and subsequent frontal cortical brain biopsy during ventriculoperitoneal shunting. Tissue amyloid-β was evaluated using the monoclonal antibody 4G8, thioflavin S and Bielschowsky silver stain.; Results: Four of the 17 patients (23.5%) had amyloid-β pathology based on the overall pathology read and also showed increased [(18)F]flutemetamol uptake. [(18)F]Flutemetamol standardized uptake values from the biopsy site were significantly associated with biopsy specimen amyloid-β levels (Pearson’s r = 0.67; p = 0.006). There was also good correlation between the biopsy specimen amyloid-β level and uptake of [(18)F]flutemetamol in the region contralateral to the biopsy site (r = 0.67; p = 0.006), as well as with composite cortical [(18)F]flutemetamol uptake (r = 0.65; p = 0.008). The blinded visual read showed a high level of agreement between all readers (κ = 0.88). Two of 3 readers were in full agreement on all images; 1 reader disagreed on 1 of the 17 NPH cases. Blinded visual assessments of PET images by 1 reader were associated with 100% sensitivity to the overall pathology read, and assessments by the 2 others were associated with 75% sensitivity (overall sensitivity by majority read was 75%); specificity of all readers was 100%.; Conclusions: [(18)F]Flutemetamol detects brain amyloid-β in vivo and shows promise as a valuable tool to study and possibly facilitate diagnosis of Alzheimer’s disease both in patients with suspected NPH and among the wider population.;

Bibtex Citation

@article{Rinne_2013, doi = {10.1159/000355256}, url = {}, year = 2013, publisher = {S. Karger {AG}}, author = {Juha O. Rinne and Janek Frantzen and Ville Leinonen and Kimmo Lonnrot and Aki Laakso and Kirsi A. Virtanen and Olof Solin and Anna Kotkansalo and Anne Koivisto and Juha Sajanti and Atte Karppinen and Hanna Lehto and Jaana Rummukainen and Chris Buckley and Adrian Smith and Paul A. Jones and Paul Sherwin and Gill Farrar and Richard McLain and Marita Kailajarvi and Igor D. Grachev}, title = {Prospective Flutemetamol Positron Emission Tomography and Histopathology in Normal Pressure Hydrocephalus}, journal = {Neurodegenerative Diseases} }


aged, aid, alzheimer disease, analysis, aniline compounds, as, benzothiazoles, diagnostic, diagnostic use, female, humans, hydrocephalus, normal pressure, identification, male, middle aged, of, pathology, prospective studies, radionuclide imaging

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Cohort Study

Type of Outcomes


Type of Interventions

Diagnostic Target Identification

Diagnostic Targets

Neuroimaging (e.g. MRI, PET, CAT etc.)