Pittsburgh compound-B (PiB), an amyloid-binding positron emission tomography (PET) tracer, is widely used for imaging amyloid-β in those with and at risk for Alzheimer disease. Here, we report on an otherwise normal 68-year-old female with abnormally high and very focal PiB retention. Coregistered T1-weighted magnetic resonance imaging and dynamic 2-fluoro-2-deoxy-D-glucose (FDG) images confirmed that the focal PiB enhancement was in the superior sagittal and transverse sinuses, outside of the adjacent cortex. Flow through the venous vasculature was normal as assessed by dynamic FDG PET imaging. These features supported the conclusion that PiB retention was not simply due to a hemodynamic abnormality, but may have represented PiB binding to fibrillar deposits of a β-sheet protein (ie, amyloid), whose nature is currently unclear.

The 5th annual Mild Cognitive Impairment Symposium, held on April 13th and 14th, 2007, in Miami Beach, Florida, focused on the question of whether the time has come to revise criteria for Alzheimer disease (AD). The symposium, sponsored by the Wien Center for Alzheimer's Disease and Memory Disorders, Mt Sinai Medical Center in Miami Beach, Florida; and the Byrd Alzheimer Center and Research Institute in Tampa, Florida, brought together an international group of clinicians and researchers to examine current evidence for developing new criteria for AD and for outlining areas that still require clarification. Neuropathologic, neuroimaging, epidemiologic, and clinical perspectives were presented and discussed, as well as the impact of ethnic and cultural differences. As became evident, each perspective introduces different challenges in terms of selecting the appropriate assessment tools; determining when, where, and by whom the diagnosis should be given; and deciding whether multiple sets of criteria are needed for use in different settings, for example, research versus primary care practices. As was intended, the symposium delivered no consensus; however, there was substantial support for the idea that AD can and probably should be diagnosed before the onset of dementia, particularly as new interventions become available.

Alzheimer's Disease Center and Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology, Center for Neuroscience, University of California, Sacramento, CA

Bristow, Karrah Q.*; Au, Rhoda*; Massaro, Joseph M.† ‡; Seshadri, Sudha*; Wolf, Philip A.*; Kelly-Hayes, Margaret*; DeCarli, Charles§ Author Information

During the first two decades of the life of this Journal (ADAD) much progress has been made in our understanding of Alzheimer disease (AD). Advancing knowledge, however, has been accompanied by increasing appreciation of the complexity and heterogeneity of this disease. Prevention and cure continue to elude us as the number of afflicted and the cost of their care continues to increase. New techniques together with long-term prospective follow-up studies, as well as utilization of data accumulated in existing data bases, are needed to move the field forward. We expect that during the next two decades, as new information accrues, reports published in ADAD will continue to contribute to the dissemination and elucidation of critical issues in Alzheimer research.

Alzheimer Disease & Associated Disorders: July 2005 - Volume 19 - Issue 3 - p 162 doi: 10.1097/01.wad.0000175524.91480.84

Alzheimer Center/ Department of Neurology, Vrije University Medical Center, Amsterdam, the Netherlands