ADmark® Alzheimer's Evaluation, CSF

Test Code
ALZ


Quest Code
92433


Alias/See Also
ALZHEIMER‚S EVALUATION


CPT Codes
84393, 82234, 84394

Includes
Beta-Amyloid (1-42), CSF
tTau, CSF
pTau181, CSF
tTau/Abeta42 Ratio
pTau181/Abeta42 Ratio


Preferred Specimen
2.5 mL CSF collected in a 2.5 mL Sarstedt low-bind false bottom tube (63.614.625, Quest Diagnostics supply part # ST100)


Minimum Volume
1 mL Sarstedt low-bind false bottom tube • 0.7 mL Sarstedt low protein-binding tube


Other Acceptable Specimens
1.5 mL CSF collected in a 1.5 mL Sarstedt low protein-binding tube (72.703.600)


Instructions
Perform lumbar puncture (LP) using gravity drip collection method. Avoid the use of syringes or tubings. Perform lumbar puncture (LP) before noon. Do not use the first 2 mL of CSF for AD Biomarker measurement. Subsequently, collect 2.5 mL of CSF directly into 2.5 mL Sarstedt (63.614.625) tube, or 1.5 mL of CSF directly into 1.5 mL Sarstedt (72.703.600) tube, for AD biomarker measurements. Filling tube at least 50% full is recommended. Each sample should be visually inspected for hemolysis. Do not use CSF samples which appear reddish. Instead, collect additional clear (non-hemolytic) CSF in a new Sarstedt tube.

Do not process the CSF sample before transport to the measuring site (i.e., no mixing/inverting, no tube transfers, no aliquoting, and normally no centrifugation) until measurement. It is strongly recommended that the sample be kept at 2 to 8° C or -15 to -25° C during transport and storage up to the time of measurement.

Only the specimen listed is acceptable for use with this assay. Standard CSF polystyrene collection tubes are NOT acceptable as exposing CSF to polystyrene tubes may decrease Abeta42 concentrations.


Transport Temperature
Refrigerated (cold packs)


Specimen Stability
Room temperature: 5 days
Refrigerated: 14 days
Frozen: 56 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Polystyrene and polypropylene tubes other than Sarstedt (63.614.625) 2.5 mL and (72.703.600) 1.5 mL


Methodology
Electrochemiluminescence (ECLIA)

Setup Schedule
Set up: Mon, Wed, Fri, Sat; Report available: 3-5 days


Reference Range
Beta-Amyloid (1-42), CSFNot established
tTau, CSFNot established
pTau181, CSFNot established
tTau/Abeta42 Ratio≤0.28
pTau181/Abeta42 Ratio≤0.023


Clinical Significance
Elecsys Beta Amyloid (1 42) CSF II, Phospho-Tau (181P) CSF and Elecsys Total Tau CSF are in vitro electrochemiluminescence immunoassays for the measurement of the Beta Amyloid (1 42) (Abeta42), PTau (181P) and Total Tau (tTau) protein concentration in cerebrospinal fluid (CSF) from adult patients aged 55 years and older being evaluated for Alzheimer's disease (AD) and other causes of cognitive impairment to generate a tTau/Abeta42 and pTau-181/Abeta42 ratios and values. A negative result, defined as tTau/Abeta42 and Phospho-Tau (181P) ratio values below cutoff or an Abeta42 value above the measuring range, are consistent with a negative amyloid positron emission tomography (PET) scan result. A negative result reduces the likelihood that a patient's cognitive impairment is due to AD. A positive result, defined as tTau/Abeta42 and pTau181/Abeta42 ratio value above cutoff, is consistent with a positive amyloid PET scan result. A positive result does not establish a diagnosis of AD or other cognitive disorder. The tTau/Abeta42 and pTau181/Abeta42 ratio results are used as an adjunct to other clinical diagnostic evaluations.


Performing Laboratory
Quest Diagnostics Nichols Institute-San Juan Capistrano, CA
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.