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Negative Amyloid PET Imaging in a Patient With Probable Alzheimer's Disease

Hellwig, Sabine MD*; Hüll, Michael MD; Meyer, Philipp T. MD, PhD

doi: 10.1097/RLU.0b013e3182335e08
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Amyloid positron emission tomography (PET) has emerged as an in vivo technique for visualizing the accumulation of fibrillar amyloid-beta (Aβ). Carbon-11 Pittsburgh compound-B (C-11 PIB) has gained widespread acceptance as a standard amyloid PET probe. We report a case of a 53-year-old woman with probable Alzheimer's disease (AD) confirmed by neuropsychological assessment and cerebrospinal fluid analyses. Fluorine-18 fluorodeoxyglucose PET depicted an AD-typical pattern of cortical hypometabolism. Unexpectedly, C-11 PIB PET detected no cortical Aβ depositions. The present case challenges the notion that a negative C-11 PIB scan excludes AD and argues for a comprehensive diagnostic workup.

From the *Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany; †Centre for Geriatric Medicine and Gerontology, University Hospital Freiburg, Freiburg, Germany; and ‡Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany.

Received for publication January 28, 2011; revision accepted June 27, 2011.

Conflicts of interest and sources of funding: none declared.

Reprints: Sabine Hellwig, MD, Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. E-mail:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.