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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor and Senior Consultant Ian Law, University of Copenhagen, Denmark
- Second opponent: Post-doc researcher and Project manager Lyduine Collij, Amsterdam UMC - University Medical Centers, The Netherlands
- Third member and chair of the evaluation committee: Professor and Head of Department Mathias Toft, Faculty of Medicine, University of Oslo
Chair of the Defence
Associate Professor Gunnar Sandbæk, University of Oslo
Principal Supervisor
Professor Mona Elisabeth Rootwelt-Revheim, Faculty of Medicine, University of Oslo
Summary
Alzheimer´s disease (AD) is a devastating brain disease and the most common cause of dementia. Plaques found in the cortex considered a hallmark of the disease, may be demonstrated 10-20 years before the onset of symptoms. They contain amyloid-beta (Aβ) protein which has routinely been detected by measuring Aβ42 in the cerebrospinal fluid (CSF). The CSF biomarker may support a clinical diagnosis and be used to evaluate eligibility for drug trials. CSF sampling is, however, not always desirable, or possible.
Positron emission tomography (PET) computed tomography (CT) using a radioactive tracer called [18F]Flutemetamol to detect these plaques was introduced in Norway in 2015 . Ebba Gløersen Müller and coworkers wanted to examine the usefulness of this method in clinical routine.
[18F]Flutemetamol binds to fibrillary forms of Aβ, present in the cortical plaques. The primary aim was to investigate the correlation between the two Aβ-biomarkers. Second, they wanted to estimate biomarker thresholds for both PET and CSF.
They included 195 persons assessed for cognitive complaints. All had undergone PET imaging with [18F]Flutemetamol and 64 had undergone lumbar puncture. PET images were visually classified and tracer uptake was measured using different software.
They found a very strong link between the two Aβ- biomarkers, supporting previous studies showing that Aβ-PET is a useful biomarker for AD alongside the CSF biomarker routinely used in Norway. The threshold for (Aβ42) in CSF was verified.
All software for measuring tracer uptake in the PET images were equally good when standard visual assessment was applied as the truth, supporting its use in clinical routine. Thresholds for abnormal uptake were defined, useful for equivocal scans by visual assessment.
They found no association between the measured tracer uptake at PET and progression in clinical AD. This suggests that other factors may be more useful for estimating prognosis.
Additional information
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