Diagnostic tests for Creutzfeldt-Jakob disease: Sensitivity and specificity
| Testing | Sensitivity | Specificity | Diagnostic criteria | Notes |
|---|---|---|---|---|
| Magnetic resonance imaging | ||||
| DWI or FLAIR30 | 83% | 83% | At least 2 cortical regions affected (parietal–temporal–occipital) or both putamen and nucleus caudatum affected | Retrospective evaluation of pathology-proven CJD |
| DWI and FLAIR31 | 91% | 95% | 2005 UCSF MRI criteria for CJD31 | Retrospective evaluation of clinically diagnosed prion disease, majority spontaneous CJD (83%); excellent interreader reliability (kappa 0.96) |
| DWI and FLAIR32 | 96% | 93% | 2005 UCSF MRI criteria for CJD31 | Retrospective evaluation of clinically diagnosed prion disease, majority spontaneous CJD (79%) |
| DWI33 | 92% | 94% | High-intensity lesions in the striatum (caudate or putamen, or both), lesions in the thalamus including the pulvinar, and/or lesions along the cortical ribbon (cerebral or cerebellar) | Retrospective evaluation of clinically diagnosed prion disease, majority spontaneous CJD (78%) |
| Electroencephalography32 | ||||
| 64% | 91% | 1996 Steinhoff criteria27 | Retrospective evaluation of pathology-proven CJD | |
| Cerebrospinal fluid studies34 | ||||
| 14-3-3 protein | 83% | 63% | Positive test | Retrospective analysis of 111 neuropathologically confirmed sCJD cases |
| Total tau protein | 91% 46% | Positive test | ||
| RT-QuIC | 92% 99% | Positive test | ||
CJD = Creutzfeldt-Jakob disease; DWI = diffusion-weighted imaging; FLAIR = fluid-attenuated inversion recovery; RT-QulC = real-time quaking-induced conversion; sCJD = sporadic Creutzfeldt-Jakob disease; UCSF = University of California, San Francisco