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Sun X, Liu F, Liu Q, Gai Y, Ruan W, Wimalarathne DN, Hu F, Tan X, Lan X. Quantitative Research of 11C-CFT and 18F-FDG PET in Parkinson's Disease: A Pilot Study With NeuroQ Software. Front Neurosci 2019; 13:299. [PMID: 31024233 PMCID: PMC6460224 DOI: 10.3389/fnins.2019.00299] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/15/2019] [Indexed: 12/15/2022] Open
Abstract
Dopamine transporter (DAT) and glucose metabolism imaging have been applied in the diagnosis of Parkinson’s disease (PD). We explored the possibility of evaluating for PD with NeuroQ software by analyzing 11C-2β-carbomethoxy-3β-(4-fluorophenyl) tropane (11C-CFT) and 18F-FDG PET/CT. We retrospectively analyzed brain 11C-CFT and 18F-FDG PET/CT of 38 patients with parkinsonism, including 20 with PD, 10 with multiple system atrophy (MSA) and 8 with essential tremor (ET), and compared them with the PET/CT of 11 normal healthy controls (NC). PD patients were divided into mild and moderate-severe grade according to the Hoehn-Yahr (H&Y) scale. The 11C-CFT uptake in the caudate nuclei (CN) and putamen (Pu) normalized with cerebellum (CN/Cb and Pu/Cb) were obtained with a manual method and NeuroQ software, and their diagnostic performance was compared.18F-FDG uptake of specific regions was also obtained with NeuroQ, and the enhancement effect for the differential diagnosis was evaluated. There was significant agreement between the manual method and the NeuroQ method for 11C-CFT uptake by CN (r2= 0.680) and Pu (r2= 0.770). 11C-CFT uptake by CN and Pu in PD and MSA patients was significantly lower compared to NC and ET patients. The cutoffs of CN/Cb and Pu/Cb for the distinction between PD and NC were 1.71 and 2.20, respectively. No difference in uptake ratios occurred between PD and MSA. 18F-FDG uptake by the pons and cerebellum in the MSA group was markedly decreased. It was highly accurate in distinguishing between PD and MSA when combined with analysis of 11C-CFT uptake. Pu/Cb decreased significantly in mild grade PD compared to NC group (1.92 ± 0.33 vs. 2.82 ± 0.43); however no statistically significant decrease in CN/Cb was observed until moderate-severe grade PD (1.43 ± 0.11 vs. 2.23 ± 0.36). In early asymmetric PD, a statistically significant difference could be seen with Pu/Cb between the symptomatic and asymptomatic side (2.17 ± 0.30 vs. 1.95 ± 0.22). 11C-CFT and 18F-FDG PET/CT can be analyzed quantitatively with NeuroQ software, which provides an accurate method for the diagnosis and severity evaluation of PD.
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Affiliation(s)
- Xun Sun
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Fang Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Qingyao Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yongkang Gai
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Weiwei Ruan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Dilani Neranjana Wimalarathne
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Fan Hu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xubo Tan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan, China
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Vāvere AL, Scott PJH. Clinical Applications of Small-molecule PET Radiotracers: Current Progress and Future Outlook. Semin Nucl Med 2017; 47:429-453. [PMID: 28826519 DOI: 10.1053/j.semnuclmed.2017.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Radiotracers, or radiopharmaceuticals, are bioactive molecules tagged with a radionuclide used for diagnostic imaging or radiotherapy and, when a positron-emitting radionuclide is chosen, the radiotracers are used for PET imaging. The development of novel PET radiotracers in many ways parallels the development of new pharmaceuticals, and small molecules dominate research and development pipelines in both disciplines. The 4 decades since the introduction of [18F]FDG have seen the development of many small molecule PET radiotracers. Ten have been approved by the US Food and Drug Administration as of 2016, whereas hundreds more are being evaluated clinically. These radiotracers are being used in personalized medicine and to support drug discovery programs where they are greatly improving our understanding of and ability to treat diseases across many areas of medicine including neuroscience, cardiovascular medicine, and oncology.
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Affiliation(s)
- Amy L Vāvere
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, MI.
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