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Fettahoglu A, Zhao M, Khalighi M, Vossler H, Jovin M, Davidzon G, Zeineh M, Boada F, Mormino E, Henderson VW, Moseley M, Chen KT, Zaharchuk G. Early-Frame [ 18F]Florbetaben PET/MRI for Cerebral Blood Flow Quantification in Patients with Cognitive Impairment: Comparison to an [ 15O]Water Gold Standard. J Nucl Med 2024; 65:306-312. [PMID: 38071587 PMCID: PMC10858379 DOI: 10.2967/jnumed.123.266273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/24/2023] [Indexed: 02/03/2024] Open
Abstract
Cerebral blood flow (CBF) may be estimated from early-frame PET imaging of lipophilic tracers, such as amyloid agents, enabling measurement of this important biomarker in participants with dementia and memory decline. Although previous methods could map relative CBF, quantitative measurement in absolute units (mL/100 g/min) remained challenging and has not been evaluated against the gold standard method of [15O]water PET. The purpose of this study was to develop and validate a minimally invasive quantitative CBF imaging method combining early [18F]florbetaben (eFBB) with phase-contrast MRI using simultaneous PET/MRI. Methods: Twenty participants (11 men and 9 women; 8 cognitively normal, 9 with mild cognitive impairment, and 3 with dementia; 10 β-amyloid negative and 10 β-amyloid positive; 69 ± 9 y old) underwent [15O]water PET, phase-contract MRI, and eFBB imaging in a single session on a 3-T PET/MRI scanner. Quantitative CBF images were created from the first 2 min of brain activity after [18F]florbetaben injection combined with phase-contrast MRI measurement of total brain blood flow. These maps were compared with [15O]water CBF using concordance correlation (CC) and Bland-Altman statistics for gray matter, white matter, and individual regions derived from the automated anatomic labeling (AAL) atlas. Results: The 2 methods showed similar results in gray matter ([15O]water, 55.2 ± 14.7 mL/100 g/min; eFBB, 55.9 ± 14.2 mL/100 g/min; difference, 0.7 ± 2.4 mL/100 g/min; P = 0.2) and white matter ([15O]water, 21.4 ± 5.6 mL/100 g/min; eFBB, 21.2 ± 5.3 mL/100 g/min; difference, -0.2 ± 1.0 mL/100 g/min; P = 0.4). The intrasubject CC for AAL-derived regions was high (0.91 ± 0.04). Intersubject CC in different AAL-derived regions was similarly high, ranging from 0.86 for midfrontal regions to 0.98 for temporal regions. There were no significant differences in performance between the methods in the amyloid-positive and amyloid-negative groups as well as participants with different cognitive statuses. Conclusion: We conclude that eFBB PET/MRI can provide robust CBF measurements, highlighting the capability of simultaneous PET/MRI to provide measurements of both CBF and amyloid burden in a single imaging session in participants with memory disorders.
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Affiliation(s)
- Ates Fettahoglu
- Department of Radiology, Stanford University, Stanford, California
- Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Moss Zhao
- Department of Radiology, Stanford University, Stanford, California
- Stanford Cardiovascular Institute, Stanford University, Stanford, California
| | - Mehdi Khalighi
- Department of Radiology, Stanford University, Stanford, California
| | - Hillary Vossler
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, California; and
| | - Maria Jovin
- Department of Radiology, Stanford University, Stanford, California
| | - Guido Davidzon
- Department of Radiology, Stanford University, Stanford, California
| | - Michael Zeineh
- Department of Radiology, Stanford University, Stanford, California
| | - Fernando Boada
- Department of Radiology, Stanford University, Stanford, California
| | - Elizabeth Mormino
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, California; and
| | - Victor W Henderson
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, California; and
| | - Michael Moseley
- Department of Radiology, Stanford University, Stanford, California
| | - Kevin T Chen
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, California
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Choi HJ, Seo M, Kim A, Park SH. Generation of Conventional 18F-FDG PET Images from 18F-Florbetaben PET Images Using Generative Adversarial Network: A Preliminary Study Using ADNI Dataset. Medicina (Kaunas) 2023; 59:1281. [PMID: 37512092 PMCID: PMC10385186 DOI: 10.3390/medicina59071281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) (PETFDG) image can visualize neuronal injury of the brain in Alzheimer's disease. Early-phase amyloid PET image is reported to be similar to PETFDG image. This study aimed to generate PETFDG images from 18F-florbetaben PET (PETFBB) images using a generative adversarial network (GAN) and compare the generated PETFDG (PETGE-FDG) with real PETFDG (PETRE-FDG) images using the structural similarity index measure (SSIM) and the peak signal-to-noise ratio (PSNR). Materials and Methods: Using the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, 110 participants with both PETFDG and PETFBB images at baseline were included. The paired PETFDG and PETFBB images included six and four subset images, respectively. Each subset image had a 5 min acquisition time. These subsets were randomly sampled and divided into 249 paired PETFDG and PETFBB subset images for the training datasets and 95 paired subset images for the validation datasets during the deep-learning process. The deep learning model used in this study is composed of a GAN with a U-Net. The differences in the SSIM and PSNR values between the PETGE-FDG and PETRE-FDG images in the cycleGAN and pix2pix models were evaluated using the independent Student's t-test. Statistical significance was set at p ≤ 0.05. Results: The participant demographics (age, sex, or diagnosis) showed no statistically significant differences between the training (82 participants) and validation (28 participants) groups. The mean SSIM between the PETGE-FDG and PETRE-FDG images was 0.768 ± 0.135 for the cycleGAN model and 0.745 ± 0.143 for the pix2pix model. The mean PSNR was 32.4 ± 9.5 and 30.7 ± 8.0. The PETGE-FDG images of the cycleGAN model showed statistically higher mean SSIM than those of the pix2pix model (p < 0.001). The mean PSNR was also higher in the PETGE-FDG images of the cycleGAN model than those of pix2pix model (p < 0.001). Conclusions: We generated PETFDG images from PETFBB images using deep learning. The cycleGAN model generated PETGE-FDG images with a higher SSIM and PSNR values than the pix2pix model. Image-to-image translation using deep learning may be useful for generating PETFDG images. These may provide additional information for the management of Alzheimer's disease without extra image acquisition and the consequent increase in radiation exposure, inconvenience, or expenses.
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Affiliation(s)
- Hyung Jin Choi
- Department of Nuclear Medicine, Ulsan University Hospital, Ulsan 44033, Republic of Korea
| | - Minjung Seo
- Department of Nuclear Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
| | - Ahro Kim
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
| | - Seol Hoon Park
- Department of Nuclear Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
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Guehl NJ, Dhaynaut M, Hanseeuw BJ, Moon SH, Lois C, Thibault E, Fu JF, Price JC, Johnson KA, El Fakhri G, Normandin MD. Measurement of Cerebral Perfusion Indices from the Early Phase of [ 18F]MK6240 Dynamic Tau PET Imaging. J Nucl Med 2023; 64:968-975. [PMID: 36997330 PMCID: PMC10241011 DOI: 10.2967/jnumed.122.265072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 04/01/2023] Open
Abstract
6-(fluoro-18F)-3-(1H-pyrrolo[2,3-c]pyridin-1-yl)isoquinolin-5-amine ([18F]MK6240) has high affinity and selectivity for hyperphosphorylated tau and readily crosses the blood-brain barrier. This study investigated whether the early phase of [18F]MK6240 can be used to provide a surrogate index of cerebral perfusion. Methods: Forty-nine subjects who were cognitively normal (CN), had mild cognitive impairment (MCI), or had Alzheimer's disease (AD) underwent paired dynamic [18F]MK6240 and [11C]Pittsburgh compound B (PiB) PET, as well as structural MRI to obtain anatomic information. Arterial blood samples were collected in a subset of 24 subjects for [18F]MK6240 scans to derive metabolite-corrected arterial input functions. Regional time-activity curves were extracted using atlases available in the Montreal Neurologic Institute template space and using FreeSurfer. The early phase of brain time-activity curves was analyzed using a 1-tissue-compartment model to obtain a robust estimate of the rate of transfer from plasma to brain tissue, K 1 (mL⋅cm-3⋅min-1), and the simplified reference tissue model 2 was investigated for noninvasive estimation of the relative delivery rate, R 1 (unitless). A head-to-head comparison with R 1 derived from [11C]PiB scans was performed. Grouped differences in R 1 were evaluated among CN, MCI, and AD subjects. Results: Regional K 1 values suggested a relatively high extraction fraction. R 1 estimated noninvasively from simplified reference tissue model 2 agreed well with R 1 calculated indirectly from the blood-based compartment modeling (r = 0.99; mean difference, 0.024 ± 0.027), suggesting that robust estimates were obtained. R 1 measurements obtained with [18F]MK6240 correlated strongly and overall agreed well with those obtained from [11C]PiB (r = 0.93; mean difference, -0.001 ± 0.068). Statistically significant differences were observed in regional R 1 measurements among CN, MCI, and AD subjects, notably in the temporal and parietal cortices. Conclusion: Our results provide evidence that the early phase of [18F]MK6240 images may be used to derive a useful index of cerebral perfusion. The early and late phases of a [18F]MK6240 dynamic acquisition may thus offer complementary information about the pathophysiologic mechanisms of the disease.
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Affiliation(s)
- Nicolas J Guehl
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;
| | - Maeva Dhaynaut
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Bernard J Hanseeuw
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; and
| | - Sung-Hyun Moon
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cristina Lois
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emma Thibault
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jessie Fanglu Fu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Julie C Price
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Keith A Johnson
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marc D Normandin
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Carneiro CDG, Faria DDP, Coutinho AM, Ono CR, Duran FLDS, da Costa NA, Garcez AT, da Silveira PS, Forlenza OV, Brucki SMD, Nitrini R, Busatto G, Buchpiguel CA. Evaluation of 10-minute post-injection 11C-PiB PET and its correlation with 18F-FDG PET in older adults who are cognitively healthy, mildly impaired, or with probable Alzheimer's disease. Braz J Psychiatry 2022; 44:495-506. [PMID: 36420910 PMCID: PMC9561831 DOI: 10.47626/1516-4446-2021-2374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Positron emission tomography (PET) allows in vivo evaluation of molecular targets in neurodegenerative diseases, such as Alzheimer's disease. Mild cognitive impairment is an intermediate stage between normal cognition and Alzheimer-type dementia. In vivo fibrillar amyloid-beta can be detected in PET using [11C]-labeled Pittsburgh compound B (11C-PiB). In contrast, [18F]fluoro-2-deoxy-d-glucose (18F-FDG) is a neurodegeneration biomarker used to evaluate cerebral glucose metabolism, indicating neuronal injury and synaptic dysfunction. In addition, early cerebral uptake of amyloid-PET tracers can determine regional cerebral blood flow. The present study compared early-phase 11C-PiB and 18F-FDG in older adults without cognitive impairment, amnestic mild cognitive impairment, and clinical diagnosis of probable Alzheimer's disease. METHODS We selected 90 older adults, clinically classified as healthy controls, with amnestic mild cognitive impairment, or with probable Alzheimer's disease, who underwent an 18F-FDG PET, early-phase 11C-PiB PET and magnetic resonance imaging. All participants were also classified as amyloid-positive or -negative in late-phase 11C-PiB. The data were analyzed using statistical parametric mapping. RESULTS We found that the probable Alzheimer's disease and amnestic mild cognitive impairment group had lower early-phase 11C-PiB uptake in limbic structures than 18F-FDG uptake. The images showed significant interactions between amyloid-beta status (negative or positive). However, early-phase 11C-PiB appears to provide different information from 18F-FDG about neurodegeneration. CONCLUSIONS Our study suggests that early-phase 11C-PiB uptake correlates with 18F-FDG, irrespective of the particular amyloid-beta status. In addition, we observed distinct regional distribution patterns between both biomarkers, reinforcing the need for more robust studies to investigate the real clinical value of early-phase amyloid-PET imaging.
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Affiliation(s)
- Camila de Godoi Carneiro
- Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil,Centro de Investigação Translacional em Oncologia, Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Daniele de Paula Faria
- Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil,Centro de Investigação Translacional em Oncologia, Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Artur Martins Coutinho
- Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Carla Rachel Ono
- Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Fábio Luís de Souza Duran
- Laboratório Neuro-Imagem em Psiquiatria (LIM 21), Departamento de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Naomi Antunes da Costa
- Laboratório Neuro-Imagem em Psiquiatria (LIM 21), Departamento de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Alexandre Teles Garcez
- Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Paula Squarzoni da Silveira
- Laboratório Neuro-Imagem em Psiquiatria (LIM 21), Departamento de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Orestes Vicente Forlenza
- Laboratório de Neurociências (LIM 27), Departamento de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Departamento de Neurologia, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Ricardo Nitrini
- Departamento de Neurologia, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Geraldo Busatto
- Laboratório Neuro-Imagem em Psiquiatria (LIM 21), Departamento de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil,Correspondence: Carlos Alberto Buchpiguel, Universidade de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, CEP 01255-090, São Paulo, SP, Brazil. E-mail:
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Shen C, Wang Z, Chen H, Bai Y, Li X, Liang D, Liu X, Zheng H, Wang M, Yang Y, Wang H, Sun T. Identifying Mild Alzheimer's Disease With First 30-Min 11C-PiB PET Scan. Front Aging Neurosci 2022; 14:785495. [PMID: 35450057 PMCID: PMC9016824 DOI: 10.3389/fnagi.2022.785495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction 11C-labeled Pittsburgh compound B (11C-PiB) PET imaging can provide information for the diagnosis of Alzheimer's disease (AD) by quantifying the binding of PiB to β-amyloid deposition in the brain. Quantification index, such as standardized uptake value ratio (SUVR) and distribution volume ratio (DVR), has been exploited to effectively distinguish between healthy and subjects with AD. However, these measures require a long wait/scan time, as well as the selection of an optimal reference region. In this study, we propose an alternate measure named amyloid quantification index (AQI), which can be obtained with the first 30-min scan without the selection of the reference region. Methods 11C-labeled Pittsburgh compound B PET scan data were obtained from the public dataset "OASIS-3". A total of 60 mild subjects with AD and 60 healthy controls were included, with 50 used for training and 10 used for testing in each group. The proposed measure AQI combines information of clearance rate and mid-phase PIB retention in featured brain regions from the first 30-min scan. For each subject in the training set, AQI, SUVR, and DVR were calculated and used for classification by the logistic regression classifier. The receiver operating characteristic (ROC) analysis was performed to evaluate the performance of these measures. Accuracy, sensitivity, and specificity were reported. The Kruskal-Wallis test and effect size were also performed and evaluated for all measures. Then, the performance of three measures was further validated on the testing set using the same method. The correlations between these measures and clinical MMSE and CDR-SOB scores were analyzed. Results The Kruskal-Wallis test suggested that AQI, SUVR, and DVR can all differentiate between the healthy and subjects with mild AD (p < 0.001). For the training set, ROC analysis showed that AQI achieved the best classification performance with an accuracy rate of 0.93, higher than 0.88 for SUVR and 0.89 for DVR. The effect size of AQI, SUVR, and DVR were 2.35, 2.12, and 2.06, respectively, indicating that AQI was the most effective among these measures. For the testing set, all three measures achieved less superior performance, while AQI still performed the best with the highest accuracy of 0.85. Some false-negative cases with below-threshold SUVR and DVR values were correctly identified using AQI. All three measures showed significant and comparable correlations with clinical scores (p < 0.01). Conclusion Amyloid quantification index combines early-phase kinetic information and a certain degree of β-amyloid deposition, and can provide a better differentiating performance using the data from the first 30-min dynamic scan. Moreover, it was shown that clinically indistinguishable AD cases regarding PiB retention potentially can be correctly identified.
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Affiliation(s)
- Chushu Shen
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Zhenguo Wang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Hongzhao Chen
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Yan Bai
- Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, China
| | - Xiaochen Li
- Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, China
| | - Dong Liang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Meiyun Wang
- Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, China
| | - Yongfeng Yang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Haifeng Wang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
| | - Tao Sun
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China,*Correspondence: Tao Sun
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Raman F, Fang YHD, Grandhi S, Murchison CF, Kennedy RE, Morris JC, Massoumzadeh P, Benzinger T, Roberson ED, McConathy J. Dynamic Amyloid PET: Relationships to 18F-Flortaucipir Tau PET Measures. J Nucl Med 2022; 63:287-293. [PMID: 34049986 PMCID: PMC8805772 DOI: 10.2967/jnumed.120.254490] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 04/23/2021] [Indexed: 11/16/2022] Open
Abstract
Measuring amyloid and predicting tau status using a single amyloid PET study would be valuable for assessing brain AD pathophysiology. We hypothesized that early-frame amyloid PET (efAP) correlates with the presence of tau pathology because the initial regional brain concentrations of radioactivity are determined primarily by blood flow, which is expected to be decreased in the setting of tau pathology. Methods: The study included 120 participants (63 amyloid-positive and 57 amyloid-negative) with dynamic 18F-florbetapir PET and static 18F-flortaucipir PET scans obtained within 6 mo of each other. These subjects were predominantly cognitively intact in both the amyloid-positive (63%) and the amyloid-negative (93%) groups. Parameters for efAP quantification were optimized for stratification of tau PET positivity, assessed by either a tauopathy score or Braak regions. The ability of efAP to stratify tau positivity was measured using receiver-operating-characteristic analysis of area under the curve (AUC). Pearson r and Spearman ρ were used for parametric and nonparametric comparisons between efAP and tau PET, respectively. Standardized net benefit was used to evaluate improvement in using efAP as an additional copredictor over hippocampal volume in predicting tau PET positivity. Results: Measuring efAP within the hippocampus and summing the first 3 min of brain activity after injection showed the strongest discriminative ability to stratify for tau positivity (AUC, 0.67-0.89 across tau PET Braak regions) in amyloid-positive individuals. Hippocampal efAP correlated significantly with a global tau PET tauopathy score in amyloid-positive participants (r = -0.57, P < 0.0001). Compared with hippocampal volume, hippocampal efAP showed a stronger association with tau PET Braak stage (ρ = -0.58 vs. -0.37) and superior stratification of tau PET tauopathy score (AUC, 0.86 vs. 0.66; P = 0.002). Conclusion: Hippocampal efAP can provide additional information to conventional amyloid PET, including estimation of the likelihood of tau positivity in amyloid-positive individuals.
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Affiliation(s)
- Fabio Raman
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
- Center for Neurodegeneration and Experimental Therapeutics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Yu-Hua Dean Fang
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sameera Grandhi
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Charles F Murchison
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Richard E Kennedy
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
| | - John C Morris
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; and
| | - Parinaz Massoumzadeh
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Tammie Benzinger
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Erik D Roberson
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
- Center for Neurodegeneration and Experimental Therapeutics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jonathan McConathy
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama;
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
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7
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Myoraku A, Klein G, Landau S, Tosun D. Regional uptakes from early-frame amyloid PET and 18F-FDG PET scans are comparable independent of disease state. Eur J Hybrid Imaging 2022; 6:2. [PMID: 35039928 PMCID: PMC8763988 DOI: 10.1186/s41824-021-00123-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/10/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose Positron emission tomography (PET) imaging with amyloid-beta (Aβ) tracers and 2-[18F] fluoro-2-Deoxy-d-glucose (18F-FDG) is extensively employed in Alzheimer’s disease (AD) studies as biomarkers of AD pathology and neurodegeneration. To reduce cost and additional burdens to the patient, early-frame uptake during Aβ PET scanning has been proposed as a surrogate measure of regional glucose metabolism. Considering the disease state specific impact of AD on neurovascular coupling, we investigated to what extent the information captured in the early frames of an Aβ-PET (18F-florbetapir or 18F-florbetaben) scan is comparable to that of a 18F-FDG PET scan, independent of disease state. Method A partial correlation was performed on early-frame 18F-florbetapir and 18F-FDG regional data from 100 participants. In a secondary analysis, we compared 92 18F-florbetapir and 21 18F-florbetaben early-frame Aβ scans from cognitively unimpaired and mild cognitive impairment participants to ascertain if regional early-frame information was similar across different Aβ-PET radioligands. Results The partial correlation of early-frame 18F-florbetapir with 18F-FDG was significant in all 84 brain ROIs, with correlation values ranging from 0.61 to 0.94. There were no significant differences between early-frame 18F-florbetapir and 18F-florbetaben images. Conclusion Overall, we find that the regional uptake measurements from early-frame 18F-florbetapir are strongly correlated with regional glucose metabolism as measured in ground-truth 18F-FDG PET scans, regardless of disease state. Future studies should focus on longitudinal early-frame amyloid PET imaging studies to further assess the value of early-frame imaging as a marker of brain metabolic decline.
Supplementary Information The online version contains supplementary material available at 10.1186/s41824-021-00123-0.
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Affiliation(s)
- Alison Myoraku
- Northern California Institute for Research and Education, VA Medical Center, 4150 Clement Street, 114M, San Francisco, CA, 94121, USA. .,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.
| | - Gregory Klein
- Roche Pharma Research and Early Development, Basel, Switzerland
| | - Susan Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, 94720-3190, USA
| | - Duygu Tosun
- Northern California Institute for Research and Education, VA Medical Center, 4150 Clement Street, 114M, San Francisco, CA, 94121, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA
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8
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Germán F, Andres D, Leandro U, Nicolás N, Graciela L, Yanina B, Patricio C, Adriana Q, Cecilia B, Ismael C, Ismael C, de León MP, Valeria C, Feuerstein V, Sergio D, Ricardo A, Henry E, Silvia V. Connectivity and Patterns of Regional Cerebral Blood Flow, Cerebral Glucose Uptake, and Aβ-Amyloid Deposition in Alzheimer's Disease (Early and Late-Onset) Compared to Normal Ageing. Curr Alzheimer Res 2021; 18:646-655. [PMID: 34784866 DOI: 10.2174/1567205018666211116095035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/11/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this study was to investigate the differences in early (EOAD) and late (LOAD) onset of Alzheimer´s disease, as well as glucose uptake, regional cerebral blood flow (R1), amyloid depositions, and functional brain connectivity between normal young (YC) and Old Controls (OC). METHODOLOGY The study included 22 YC (37 ± 5 y), 22 OC (73 ± 5.9 y), 18 patients with EOAD (63 ± 9.5 y), and 18 with LOAD (70.6 ± 7.1 y). Patients underwent FDG and PIB PET/CT. R1 images were obtained from the compartmental analysis of the dynamic PIB acquisitions. Images were analyzed by a voxel-wise and a VOI-based approach. Functional connectivity was studied from the R1 and glucose uptake images. RESULTS OC had a significant reduction of R1 and glucose uptake compared to YC, predominantly at the dorsolateral and mesial frontal cortex. EOAD and LOAD vs. OC showed a decreased R1 and glucose uptake at the posterior parietal cortex, precuneus, and posterior cingulum. EOAD vs. LOAD showed a reduction in glucose uptake and R1 at the occipital and parietal cortex and an increased at the mesial frontal and temporal cortex. There was a mild increase in an amyloid deposition at the frontal cortex in LOAD vs. EOAD. YC presented higher connectivity than OC in R1 but lower connectivity considering glucose uptake. Moreover, EOAD and LOAD showed a decreased connectivity compared to controls that were more pronounced in glucose uptake than R1. CONCLUSION Our results demonstrated differences in amyloid deposition and functional imaging between groups and a differential pattern of functional connectivity in R1 and glucose uptake in each clinical condition. These findings provide new insights into the pathophysiological processes of AD and may have an impact on patient diagnostic evaluation.
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Affiliation(s)
- Falasco Germán
- Centro de Imagenes Moleculares, Fleni. Ruta 9, km 52.5, B1625XAF Escobar, Buenos Aires, Argentina
| | - Damian Andres
- Centro Uruguayo de Imagenologia Molecular, CUDIM. Av. Ricaldoni 2010, Montevideo, Uruguay
| | - Urrutia Leandro
- Centro de Imagenes Moleculares, Fleni. Ruta 9, km 52.5, B1625XAF Escobar, Buenos Aires, Argentina
| | - Niell Nicolás
- Centro Uruguayo de Imagenologia Molecular, CUDIM. Av. Ricaldoni 2010, Montevideo, Uruguay
| | - Lago Graciela
- Centro Uruguayo de Imagenologia Molecular, CUDIM. Av. Ricaldoni 2010, Montevideo, Uruguay
| | - Bérgamo Yanina
- Departamento de Neurología Cognitiva, Neuropsiquiatria y Neuropsicología, Fleni. Montaneses 2325, C1428AQK, Ciudad de Buenos Aires, Argentina
| | - Chrem Patricio
- Departamento de Neurología Cognitiva, Neuropsiquiatría y Neuropsicología, Fleni. Montañeses 2325, C1428AQK, Ciudad de Buenos Aires, Argentina
| | - Quagliata Adriana
- Centro Uruguayo de Imagenologia Molecular, CUDIM. Av. Ricaldoni 2010, Montevideo, Uruguay
| | - Bentancourt Cecilia
- Centro Uruguayo de Imagenologia Molecular, CUDIM. Av. Ricaldoni 2010, Montevideo, Uruguay
| | - Calandri Ismael
- Departamento de Neurología Cognitiva, Neuropsiquiatria y Neuropsicología, Fleni. Montaneses 2325, C1428AQK, Ciudad de Buenos Aires, Argentina
| | - Cordero Ismael
- Centro Uruguayo de Imagenologia Molecular, CUDIM. Av. Ricaldoni 2010, Montevideo, Uruguay
| | - Magdalena Ponce de León
- Centro de Imagenes Moleculares, Fleni. Ruta 9, km 52.5, B1625XAF Escobar, Buenos Aires, Argentina
| | - Contreras Valeria
- Departamento de Neuropsicología, Instituto de Neurologia, Hospital de Clinicas, Montevideo, Uruguay
| | - Viviana Feuerstein
- Departamento de Neuropsicología, Instituto de Neurologia, Hospital de Clinicas, Montevideo, Uruguay
| | - Dansilio Sergio
- Departamento de Neuropsicología, Instituto de Neurologia, Hospital de Clinicas, Montevideo, Uruguay
| | - Allegri Ricardo
- Departamento de Neurología Cognitiva, Neuropsiquiatria y Neuropsicología, Fleni. Montaneses 2325, C1428AQK, Ciudad de Buenos Aires, Argentina
| | - Engler Henry
- Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Vazquez Silvia
- Centro de Imagenes Moleculares, Fleni. Ruta 9, km 52.5, B1625XAF Escobar, Buenos Aires, Argentina
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9
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Kwon SJ, Ha S, Yoo SW, Shin NY, O JH, Yoo IR, Kim JS. Comparison of early F-18 Florbetaben PET/CT to Tc-99m ECD SPECT using voxel, regional, and network analysis. Sci Rep 2021; 11:16738. [PMID: 34408171 PMCID: PMC8373880 DOI: 10.1038/s41598-021-95808-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022] Open
Abstract
This study aimed to validate early-phase F-18 Florbetaben positron emission tomography (eFBB PET) as a brain perfusion test and determine the optimal reference region. A total of 27 patients with early Parkinson's disease with Tc-99m ethyl cysteinate dimer single photon emission tomography (ECD SPECT) and FBB PET were included. Six reference regions, including whole brain (GN), pons, central white matter (CWM), whole cerebellum (WC), WC with brain stem (WC + B), and cerebellar grey matter (CG), were applied to obtain SUVR using cortex volume-of-interest (VOI). Reference regions of WC (r 0.886), WC + B (r 0.897), and CG (r 0.904) had highest correlation values of cortex-VOI SUVR between both perfusion images (all p < 0.001). Early-phase FBB PET had a significant linear correlation of CG-normalized SUVR of the cortex, basal ganglia, thalamus, and midbrain with ECD SPECT in voxel-wise analysis (FDR adjusted-p < 0.05). Early-phase FBB PET extracts more ICNS than ECD SPECT, as 9 ICNS and 4 ICNs, respectively. Both eFBB PET and ECD SPECT well discriminated PD from DLB (Area-under-curve of receiver-operating-characteristics, 0.911 for eFBB PET, 0.922 for ECD SPECT). Our findings suggest that eFBB PET is a reliable perfusion test based on a high correlation with ECD SPECT using cerebellum-based normalization methods.
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Affiliation(s)
- Soo Jin Kwon
- Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Seunggyun Ha
- Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
| | - Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joo Hyun O
- Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Ie Ryung Yoo
- Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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10
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Yoon HJ, Kim BS, Jeong JH, Kim GH, Park HK, Chun MY, Ha S. Dual-phase 18F-florbetaben PET provides cerebral perfusion proxy along with beta-amyloid burden in Alzheimer's disease. Neuroimage Clin 2021; 31:102773. [PMID: 34339946 PMCID: PMC8346681 DOI: 10.1016/j.nicl.2021.102773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study investigated changes in brain perfusion and Aβ burden according to the progression of Alzheimer's disease (AD) by using a dual-phase 18F-florbetaben (FBB) PET protocol. METHODS Sixty subjects, including 12 with Aβ-negative normal cognition (Aβ-NC), 32 with Aβ-positive mild cognitive impairment (Aβ+MCI), and 16 with Aβ-positive AD (Aβ+AD), were enrolled. A dynamic PET scan was obtained in the early phase (0-10 min, eFBB) and delayed phase (90-110 min, dFBB), which were then averaged into a single frame, respectively. In addition to the averaged eFBB, an R1 parametric map was calculated from the eFBB scan based on a simplified reference tissue model (SRTM). Between-group regional and voxel-wise analyses of the images were performed. The associations between cognitive profiles and PET-derived parameters were investigated. RESULTS Both the R1 and eFBB perfusion reductions in the cortical regions were not significantly different between the Aβ-NC and Aβ+MCI groups, while they were significantly reduced from the Aβ+MCI to Aβ+AD groups in regional and voxel-wise analyses. However, cortical Aβ depositions on dFBB were not significantly different between the Aβ+MCI and Aβ+AD groups. There were strong positive correlations between the R1 and eFBB images in regional and voxel-wise analyses. Both perfusion components showed significant correlations with general and specific cognitive profiles. CONCLUSION The results of this study demonstrated the feasibility of dual-phase 18F-FBB PET to evaluate different trajectories of dual biomarkers for neurodegeneration and Aβ burden over the course of AD. In addition, both eFBB and SRTM-based R1 can provide robust indices of brain perfusion.
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Affiliation(s)
- Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
| | - Bom Sahn Kim
- Department of Nuclear Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea.
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea.
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea
| | - Hee Kyung Park
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea; Division of Psychiatry, Department of mental health care of older people, University College London, London, UK
| | - Min Young Chun
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea
| | - Seunggyun Ha
- Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Tiepolt S, Luthardt J, Patt M, Hesse S, Hoffmann KT, Weise D, Gertz HJ, Sabri O, Barthel H. Early after Administration [11C]PiB PET Images Correlate with Cognitive Dysfunction Measured by the CERAD Test Battery. J Alzheimers Dis 2020; 68:65-76. [PMID: 30636731 DOI: 10.3233/jad-180217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Amyloid-β (Aβ) and [18F]FDG PET are established as amyloid pathology and neuronal injury biomarkers. Early after administration Aβ PET images have the potential to replace [18F]FDG PET images allowing dual biomarker delivery by the administration of a single tracer. For [18F]FDG PET data, a correlation with cognitive performance is known. OBJECTIVE The aim of this study was to investigate whether early after administration [11C]PiB PET data also correlate with cognitive performance. METHODS The early after administration [11C]PiB PET data of 31 patients with cognitive impairment were evaluated. CERAD subtests were summarized to five cognitive domains. The resulting z scores were correlated with the PET data on a voxel- and VOI-based approach. Additional subgroup analyses (MCI versus dementia, Aβ-positive versus Aβ-negative subjects) were performed. RESULTS Significant correlations between cognitive performance and early after administration [11C]PiB PET data were found between left temporo-parietal SUVR and language domain, bilateral occipital as well as left temporal SUVR and executive function, left pre- and postcentral SUVRs, and visuospatial abilities. For the episodic and immediate memory domains, the analysis at the high significance level did not show any correlated cluster, however, the exploratory analysis did. CONCLUSION Our study revealed correlations between deficits in different cognitive domains and regional early after administration [11C]PiB PET data similar to those known from [18F]FDG PET studies. Thus, our data support the assumption that early [11C]PiB PET data have a potential as neuronal injury biomarker. Head-to-head double-tracer studies of larger cohorts are needed to confirm this assumption.
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Affiliation(s)
- Solveig Tiepolt
- Department of Nuclear Medicine, University of Leipzig, University of Leipzig, Leipzig, Germany
| | - Julia Luthardt
- Department of Nuclear Medicine, University of Leipzig, University of Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, University of Leipzig, Leipzig, Germany
| | - Swen Hesse
- Department of Nuclear Medicine, University of Leipzig, University of Leipzig, Leipzig, Germany
| | | | - David Weise
- Department of Psychiatry, University of Leipzig, Leipzig, Germany.,Department of Neurology, University of Leipzig, Leipzig, Germany
| | | | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, University of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, University of Leipzig, Leipzig, Germany
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12
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Kero T, Sörensen J, Antoni G, Wilking H, Carlson K, Vedin O, Rosengren S, Wikström G, Lubberink M. Quantification of 11C-PIB kinetics in cardiac amyloidosis. J Nucl Cardiol 2020; 27:774-784. [PMID: 30039218 PMCID: PMC7326793 DOI: 10.1007/s12350-018-1349-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/23/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND The purpose of this work was to determine the optimal tracer kinetic model of 11C-PIB and to validate the use of the simplified methods retention index (RI) and standardized uptake value (SUV) for quantification of cardiac 11C-PIB uptake in amyloidosis. METHODS AND RESULTS Single-tissue, reversible and irreversible two-tissue models were fitted to data from seven cardiac amyloidosis patients who underwent 11C-PIB PET scans and arterial blood sampling for measurement of blood radioactivity and metabolites. The irreversible two-tissue model (2Tirr) best described cardiac 11C-PIB uptake. RI and SUV showed high correlation with the rate of irreversible binding (Ki) from the 2Tirr model (r2 =0.95 and r2 =0.94). Retrospective data from 10 amyloidosis patients and 5 healthy controls were analyzed using RI, SUV, as well as compartment modelling with a population-average metabolite correction. All measures were higher in amyloidosis patients than in healthy controls (p=.001), but with an overlap between groups for Ki. CONCLUSION An irreversible two-tissue model best describes the 11C-PIB uptake in cardiac amyloidosis. RI and SUV correlate well with Ki from the 2Tirr model. RI and SUV discriminate better between amyloidosis patients and controls than Ki based on population-average metabolite correction.
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Affiliation(s)
- Tanja Kero
- Department of Surgical Science, Uppsala University, Uppsala, Sweden.
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden.
- PET Center/Medical Imaging Center, Uppsala University Hospital, 75185, Uppsala, Sweden.
| | - Jens Sörensen
- Department of Surgical Science, Uppsala University, Uppsala, Sweden
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Gunnar Antoni
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Helena Wilking
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Kristina Carlson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Ola Vedin
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Cardiology, Uppsala University Hospital, Uppsala, Sweden
| | - Sara Rosengren
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Gerhard Wikström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Cardiology, Uppsala University Hospital, Uppsala, Sweden
| | - Mark Lubberink
- Department of Surgical Science, Uppsala University, Uppsala, Sweden
- Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden
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13
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Okazawa H, Ikawa M, Jung M, Maruyama R, Tsujikawa T, Mori T, Rahman MGM, Makino A, Kiyono Y, Kosaka H. Multimodal analysis using [ 11C]PiB-PET/MRI for functional evaluation of patients with Alzheimer's disease. EJNMMI Res 2020; 10:30. [PMID: 32232573 PMCID: PMC7105527 DOI: 10.1186/s13550-020-00619-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/19/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Multimodal PET/MRI image data simultaneously obtained from patients with early-stage of Alzheimer's disease (eAD) were assessed in order to observe pathophysiologic and functional changes, as well as alterations of morphology and connectivity in the brain. Fifty-eight patients with mild cognitive impairment and early dementia (29 males, 69 ± 12 years) underwent [11C]Pittsburgh compound-B (PiB) PET/MRI with 70-min PET and MRI scans. Sixteen age-matched healthy controls (CTL) (9 males, 68 ± 11 years) were also studied with the same scanning protocol. Cerebral blood flow (CBF) was calculated from the early phase PET images using the image-derived input function method. A standardized uptake value ratio (SUVr) was calculated from 50 to 70 min PET data with a reference region of the cerebellar cortex. MR images such as 3D-T1WI, resting-state functional MRI (RS-fMRI), diffusion tensor image (DTI), and perfusion MRI acquired during the dynamic PET scan were also analyzed to evaluate various brain functions on MRI. RESULTS Twenty-seven of the 58 patients were determined as eAD based on the results of PiB-PET and clinical findings, and a total of 43 subjects' data including CTL were analyzed in this study. PiB SUVr values in all cortical regions of eAD were significantly greater than those of CTL. The PiB accumulation intensity was negatively correlated with cognitive scores. The regional PET-CBF values of eAD were significantly lower in the bilateral parietal lobes and right temporal lobe compared with CTL, but not in MRI perfusion; however, SPM showed regional differences on both PET- and MRI-CBF. SPM analysis of RS-fMRI delineated regional differences between the groups in the anterior cingulate cortex and the left precuneus. VBM analysis showed atrophic changes in the AD group in a part of the bilateral hippocampus; however, analysis of fractional anisotropy calculated from DTI data did not show differences between the two groups. CONCLUSION Multimodal analysis conducted with various image data from PiB-PET/MRI scans showed differences in regional CBF, cortical volume, and neuronal networks in different regions, indicating that pathophysiologic and functional changes in the AD brain can be observed from various aspects of neurophysiologic parameters. Application of multimodal brain images using PET/MRI would be ideal for investigating pathophysiologic changes in patients with dementia and other neurodegenerative diseases.
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Affiliation(s)
- Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.
| | - Masamichi Ikawa
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.,Department of Neurology, Faculty of Medical Sciences, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Minyoung Jung
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.,Department of Psychiatry, Faculty of Medical Sciences, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Rikiya Maruyama
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Tetsuya Tsujikawa
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Tetsuya Mori
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Mahmudur G M Rahman
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.,Department of Biomedical Engineering, Khulna University of Engineering & Technology, Khulna, 9203, Bangladesh
| | - Akira Makino
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Yasushi Kiyono
- Biomedical Imaging Research Center, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
| | - Hirotaka Kosaka
- Department of Psychiatry, Faculty of Medical Sciences, University of Fukui, 23-3, Matsuoka-Shimaizuki, Eiheiji-cho, Fukui, 910-1193, Japan
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14
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Bilgel M, Beason-Held L, An Y, Zhou Y, Wong DF, Resnick SM. Longitudinal evaluation of surrogates of regional cerebral blood flow computed from dynamic amyloid PET imaging. J Cereb Blood Flow Metab 2020; 40:288-297. [PMID: 30755135 PMCID: PMC7370613 DOI: 10.1177/0271678x19830537] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/11/2018] [Accepted: 01/07/2019] [Indexed: 11/17/2022]
Abstract
Surrogates of neuronal activity, typically measured by regional cerebral blood flow (rCBF) or glucose metabolism, can be estimated from dynamic amyloid PET imaging. Using data for 149 participants (345 visits) from the Baltimore Longitudinal Study of Aging, we assessed whether the average of early amyloid frames (EA) and R1 computed from dynamic 11C-Pittsburgh compound B (PiB) PET can serve as surrogates of rCBF computed from 15O-H2O-PET. R1 had the highest longitudinal test-retest reliability. Interquartile range (IQR) of cross-sectional Pearson correlations with rCBF was 0.60-0.72 for EA and 0.63-0.72 for R1. Correlations between rates of change were lower (IQR 0.22-0.50 for EA, 0.25-0.55 for R1). Values in the Alzheimer's metabolic signature meta-ROI were negatively associated with age and exhibited longitudinal declines for each PET measure. In age-adjusted analyses, meta-ROI rCBF and R1 were lower among amyloid+ individuals; EA and R1 were lower among males. Regional PiB-based measures, in particular R1, can be suitable surrogates of rCBF. Dynamic PiB-PET may obviate the need for a separate scan to measure neuronal activity, thereby reducing patient burden, radioactivity exposure, and cost.
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Affiliation(s)
- Murat Bilgel
- Laboratory of Behavioral Neuroscience,
National Institute on Aging (NIA), Baltimore, USA
| | - Lori Beason-Held
- Laboratory of Behavioral Neuroscience,
National Institute on Aging (NIA), Baltimore, USA
| | - Yang An
- Laboratory of Behavioral Neuroscience,
National Institute on Aging (NIA), Baltimore, USA
| | - Yun Zhou
- Department of Radiology and Radiological
Science, Johns Hopkins University School (JHU) of Medicine, Baltimore, USA
- Mallinckrodt Institute of Radiology,
Washington University in St. Louis School of Medicine, St. Louis, USA
| | - Dean F Wong
- Department of Radiology and Radiological
Science, Johns Hopkins University School (JHU) of Medicine, Baltimore, USA
- Department of Psychiatry and Behavioral
Sciences, JHU School of Medicine, Baltimore, USA
- Department of Neuroscience, JHU School
of Medicine, Baltimore, USA
- Department of Neurology, JHU School of
Medicine, Baltimore, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience,
National Institute on Aging (NIA), Baltimore, USA
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15
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Affiliation(s)
- Marco Pagani
- Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
- Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Carletto
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy.
| | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy
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16
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Ottoy J, Verhaeghe J, Niemantsverdriet E, De Roeck E, Wyffels L, Ceyssens S, Van Broeckhoven C, Engelborghs S, Stroobants S, Staelens S. 18F-FDG PET, the early phases and the delivery rate of 18F-AV45 PET as proxies of cerebral blood flow in Alzheimer's disease: Validation against 15O-H 2O PET. Alzheimers Dement 2019; 15:1172-82. [PMID: 31405824 DOI: 10.1016/j.jalz.2019.05.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/27/2019] [Accepted: 05/21/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Dual-biomarker positron emission tomography (PET), providing complementary information on cerebral blood flow and amyloid-β deposition, is of clinical interest for Alzheimer's disease (AD). The purpose of this study was to validate the perfusion components of early-phase 18F-florbetapir (eAV45), the 18F-AV45 delivery rate (R1), and 18F-FDG against 15O-H2O PET and assess how they change with disease severity. METHODS This study included ten controls, 19 amnestic mild cognitive impairment, and 10 AD dementia subjects. Within-subject regional correlations between modalities, between-group regional and voxel-wise analyses of covariance per modality, and receiver operating characteristic analyses for discrimination between groups were performed. RESULTS FDG standardized uptake value ratio, eAV45 (0-2 min) standardized uptake value ratio, and AV45-R1 were significantly associated with H2O PET (regional Pearson r = 0.54-0.82, 0.70-0.94, and 0.65-0.92, respectively; P < .001). All modalities confirmed reduced cerebral blood flow in the posterior cingulate of patients with amnestic mild cognitive impairment and AD dementia, which was associated with lower cognition (r = 0.36-0.65, P < .025) and could discriminate between patient and control groups (area under the curve > 0.80). However, eAV45 was less sensitive to reflect the disease severity than AV45-R1 or FDG. DISCUSSION R1 is preferable over eAV45 for accurate representation of brain perfusion in dual-biomarker PET for AD.
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17
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Brown EE, Rashidi-Ranjbar N, Caravaggio F, Gerretsen P, Pollock BG, Mulsant BH, Rajji TK, Fischer CE, Flint A, Mah L, Herrmann N, Bowie CR, Voineskos AN, Graff-Guerrero A. Brain Amyloid PET Tracer Delivery is Related to White Matter Integrity in Patients with Mild Cognitive Impairment. J Neuroimaging 2019; 29:721-729. [PMID: 31270885 DOI: 10.1111/jon.12646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Amyloid deposition, tau neurofibrillary tangles, and cerebrovascular dysfunction are important pathophysiologic features in Alzheimer's disease. Pittsburgh compound B ([11 C]-PIB) is a positron emission tomography (PET) radiotracer used to quantify amyloid deposition in vivo. In addition, certain models of [11 C]-PIB delivery reflect cerebral blood flow rather than amyloid plaques. As cerebral blood flow and perfusion deficits are associated with white matter pathology, we hypothesized that [11 C]-PIB delivery in white matter regions may reflect white matter integrity. METHODS We obtained [11 C]-PIB-PET scans and quantified white matter hyperintensities and global fractional anisotropy on magnetic resonance images as biomarkers of white matter pathology in 34 older participants with mild cognitive impairment with or without a history of major depressive disorder. We analyzed the [11 C]-PIB time-activity curve data with models associated with cerebral blood flow: the early maximum standard uptake value and the relative delivery parameter R1. We used a global white matter region of interest. RESULTS Both of the partial-volume corrected PET parameters were correlated with white matter hyperintensities and fractional anisotropy. CONCLUSION Future studies are warranted to explore whether [11 C]-PIB PET is a "triple biomarker" that may provide information about amyloid deposition, cerebral blood flow, and white matter pathology.
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Affiliation(s)
- Eric E Brown
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Neda Rashidi-Ranjbar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Fernando Caravaggio
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Corinne E Fischer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Alastair Flint
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
| | - Linda Mah
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Christopher R Bowie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Queen's University, Kingston, Ontario, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Graff-Guerrero
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | -
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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18
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Sheikh-Bahaei N, Manavaki R, Sajjadi SA, Priest AN, O’Brien JT, Gillard JH. Correlation of Lobar Cerebral Microbleeds with Amyloid, Perfusion, and Metabolism in Alzheimer’s Disease. J Alzheimers Dis 2019; 68:1489-1497. [DOI: 10.3233/jad-180443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Nasim Sheikh-Bahaei
- Department of Radiology, Keck School of Medicine of USC, University of Southern California, USA
| | - Roido Manavaki
- Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - S. Ahmad Sajjadi
- Department of Neurology, University of California Irvine, CA, USA
| | - Andrew N. Priest
- Department of Radiology, Cambridge University Hospitals, Cambridge, UK
| | - John T. O’Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Jonathan H. Gillard
- Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK
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19
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Belohlavek O, Jaruskova M, Skopalova M, Szarazova G, Simonova K. Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation. Eur J Nucl Med Mol Imaging 2019; 46:297-303. [PMID: 30159586 PMCID: PMC6333723 DOI: 10.1007/s00259-018-4140-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 08/17/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE We investigated whether the reproducibility of standard visual reporting (STD method) in flutemetamol (FMM) PET can be improved using a newly introduced method that uses grey matter edges derived from the perfusion phase (GM-EDGE method). METHODS Two-phase FMM PET was performed in 121 patients with mild cognitive impairment. Five nuclear medicine physicians blindly and independently evaluated all late-phase scans, initially employing the STD method and later the GM-EDGE method. A five-point scale was used to express the degree of amyloid positivity, and a binary classification (positive/negative) was used in combination with subjective confidence (five-point scale). Multirater Fleiss' kappa, intraclass correlation coefficient (ICC) and inter-rater reliability (Cohen's kappa) were determined for the STD and GM-EDGE methods. RESULTS The weighted Cohen's kappa values for the five-point measure of amyloid positivity ranged from 0.63 to 0.73 (median 0.70) for the STD method and from 0.76 to 0.89 (median 0.80) for the GM-EDGE method (ICC 0.84, 95% CI 0.79-0.88, for the STD method; 0.91, 95% CI 0.89-0.94, for the GM-EDGE method). The nonweighted Cohen's kappa value for the binary classification ranged from 0.73 to 0.93 (median 0.82) for the STD method and 0.90 to 0.97 (median 0.93) for the GM-EDGE method (Fleiss' kappa 0.82, 95% CI 0.77-0.88, for the STD method; 0.93, 95% CI 0.87-0.99, for the GM-EDGE method). The GM-EDGE method resulted in significantly greater subjective confidence in the readings of four physicians (p < 0.010). The binary classification was concordant among all five physicians in 80.8% of the scans using the STD method and in 91.6% of the scans using the GM-EDGE method (p = 0.016). CONCLUSION The newly introduced GM-EDGE method was associated with significantly higher inter-rater agreement among physicians and higher subjective confidence in the reading. The method is easy to implement in clinical practice, especially when the perfusion phase is utilized clinically.
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Affiliation(s)
- Otakar Belohlavek
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic.
| | - Monika Jaruskova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Magdalena Skopalova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Gabriela Szarazova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Katerina Simonova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
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20
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Peretti DE, Vállez García D, Reesink FE, van der Goot T, De Deyn PP, de Jong BM, Dierckx RAJO, Boellaard R. Relative cerebral flow from dynamic PIB scans as an alternative for FDG scans in Alzheimer's disease PET studies. PLoS One 2019; 14:e0211000. [PMID: 30653612 PMCID: PMC6336325 DOI: 10.1371/journal.pone.0211000] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/04/2019] [Indexed: 11/29/2022] Open
Abstract
In Alzheimer’s Disease (AD) dual-tracer positron emission tomography (PET) studies with 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) and 11C-labelled Pittsburgh Compound B (PIB) are used to assess metabolism and cerebral amyloid-β deposition, respectively. Regional cerebral metabolism and blood flow (rCBF) are closely coupled, both providing an index for neuronal function. The present study compared PIB-derived rCBF, estimated by the ratio of tracer influx in target regions relative to reference region (R1) and early-stage PIB uptake (ePIB), to FDG scans. Fifteen PIB positive (+) patients and fifteen PIB negative (-) subjects underwent both FDG and PIB PET scans to assess the use of R1 and ePIB as a surrogate for FDG. First, subjects were classified based on visual inspection of the PIB PET images. Then, discriminative performance (PIB+ versus PIB-) of rCBF methods were compared to normalized regional FDG uptake. Strong positive correlations were found between analyses, suggesting that PIB-derived rCBF provides information that is closely related to what can be seen on FDG scans. Yet group related differences between method’s distributions were seen as well. Also, a better correlation with FDG was found for R1 than for ePIB. Further studies are needed to validate the use of R1 as an alternative for FDG studies in clinical applications.
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Affiliation(s)
- Débora E. Peretti
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
| | - David Vállez García
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
- * E-mail:
| | - Fransje E. Reesink
- Department of Neurology, Alzheimer Research Centre, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
| | - Tim van der Goot
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
| | - Peter P. De Deyn
- Department of Neurology, Alzheimer Research Centre, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
- Institute Born-Bunge, Laboratory of Neurochemistry and Behaviour, University of Antwerp, Antwerp, Antwerp, Belgium
| | - Bauke M. de Jong
- Department of Neurology, Alzheimer Research Centre, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
| | - Rudi A. J. O. Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Groningen, The Netherlands
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21
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Joseph-Mathurin N, Su Y, Blazey TM, Jasielec M, Vlassenko A, Friedrichsen K, Gordon BA, Hornbeck RC, Cash L, Ances BM, Veale T, Cash DM, Brickman AM, Buckles V, Cairns NJ, Cruchaga C, Goate A, Jack CR, Karch C, Klunk W, Koeppe RA, Marcus DS, Mayeux R, McDade E, Noble JM, Ringman J, Saykin AJ, Thompson PM, Xiong C, Morris JC, Bateman RJ, Benzinger TLS. Utility of perfusion PET measures to assess neuronal injury in Alzheimer's disease. Alzheimers Dement (Amst) 2018; 10:669-677. [PMID: 30417072 PMCID: PMC6215983 DOI: 10.1016/j.dadm.2018.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is commonly used to estimate neuronal injury in Alzheimer's disease (AD). Here, we evaluate the utility of dynamic PET measures of perfusion using 11C-Pittsburgh compound B (PiB) to estimate neuronal injury in comparison to FDG PET. Methods FDG, early frames of PiB images, and relative PiB delivery rate constants (PiB-R1) were obtained from 110 participants from the Dominantly Inherited Alzheimer Network. Voxelwise, regional cross-sectional, and longitudinal analyses were done to evaluate the correlation between images and estimate the relationship of the imaging biomarkers with estimated time to disease progression based on family history. Results Metabolism and perfusion images were spatially correlated. Regional PiB-R1 values and FDG, but not early frames of PiB images, significantly decreased in the mutation carriers with estimated year to onset and with increasing dementia severity. Discussion Hypometabolism estimated by PiB-R1 may provide a measure of brain perfusion without increasing radiation exposure.
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Affiliation(s)
- Nelly Joseph-Mathurin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Tyler M Blazey
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Mateusz Jasielec
- Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Andrei Vlassenko
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Karl Friedrichsen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Brian A Gordon
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Russ C Hornbeck
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Lisa Cash
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Thomas Veale
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - David M Cash
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Adam M Brickman
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Virginia Buckles
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Nigel J Cairns
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Alison Goate
- Neuroscience Department Laboratories, Mount Sinai School of Medicine, New York, NY, USA
| | | | - Celeste Karch
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - William Klunk
- Departments of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Daniel S Marcus
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - James M Noble
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - John Ringman
- Memory and Aging Center, Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Paul M Thompson
- Laboratory of Neuroimaging, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
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22
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Nobili F, Cagnin A, Calcagni ML, Chincarini A, Guerra UP, Morbelli S, Padovani A, Paghera B, Pappatà S, Parnetti L, Sestini S, Schillaci O. Emerging topics and practical aspects for an appropriate use of amyloid PET in the current Italian context. Q J Nucl Med Mol Imaging 2018; 63:83-92. [PMID: 29697220 DOI: 10.23736/s1824-4785.18.03069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In May 2017 some representatives of the Italian nuclear medicine and neurological communities spontaneously met to discuss the issues emerged during the first two years of routine application of amyloid PET with fluorinated radiopharmaceuticals in the real world. The limitations of a binary classification of scans, the possibility to obtain early images as a surrogate marker of regional cerebral bloos flow, the need for (semi-)quantification and, thus, the opportunity of ranking brain amyloidosis, the correlation with Aβ42 levels in the cerebrospinal fluid, the occurrence and biological meaning of uncertain/boderline scans, the issue of incidental amyloidosis, the technical pittfalls leading to false negative/positive results, the position of the tool in the diagnostic flow-chart in the national reality, are the main topics that have been discussed. Also, a card to justify the examination to be filled by the dementia specialist and a card for the nuclear medicine physician to report the exam in detail have been approved and are available in the web, which should facilitate the creation of a national register, as previewed by the 2015 intersocietal recommendation on the use of amyloid PET in Italy. The content of this discussion could stimulate both public institutions and companies to support further research on these topics.
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Affiliation(s)
- Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa and Neurology Clinic, San Martino Polyclinic Hospital, Genoa, Italy -
| | - Annachiara Cagnin
- Department of Neurosciences (DNS), University of Padua, Padua, Italy.,San Camillo IRCCS Hospital, Venice, Italy
| | - Maria L Calcagni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Chincarini
- National Institute for Nuclear Physics (INFN), Genoa Section, Genoa, Italy
| | - Ugo P Guerra
- Unit of Nuclear Medicine, Poliambulanza Fundation, Brescia, Italy
| | - Silvia Morbelli
- Unit of Nuclear Medicine, Department of Health Sciences (DISSAL), Polyclinic San Martino Hospital, University of Genoa, Genoa, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Clinic, Spedali Civili, Brescia, Italy
| | - Barbara Paghera
- Unit of Nuclear Medicine, ASST-Spedali Civili, University of Brescia, Brescia, Italy
| | - Sabina Pappatà
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - Lucilla Parnetti
- Center for Memory Disorders, Laboratory of Clinical Neurochemistry, Neurology Clinic, University of Perugia, Perugia, Italy
| | - Stelvio Sestini
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,IRCCS Neuromed, Rome, Italy
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23
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Chen YJ, Nasrallah IM. Brain amyloid PET interpretation approaches: from visual assessment in the clinic to quantitative pharmacokinetic modeling. Clin Transl Imaging 2017. [DOI: 10.1007/s40336-017-0257-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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24
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Rodriguez-Vieitez E, Leuzy A, Chiotis K, Saint-Aubert L, Wall A, Nordberg A. Comparability of [ 18F]THK5317 and [ 11C]PIB blood flow proxy images with [ 18F]FDG positron emission tomography in Alzheimer's disease. J Cereb Blood Flow Metab 2017; 37:740-749. [PMID: 27107028 PMCID: PMC5381463 DOI: 10.1177/0271678x16645593] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
For amyloid positron emission tomography tracers, the simplified reference tissue model derived ratio of influx rate in target relative to reference region (R1) has been shown to serve as a marker of brain perfusion, and, due to the strong coupling between perfusion and metabolism, as a proxy for glucose metabolism. In the present study, 11 prodromal Alzheimer's disease and nine Alzheimer's disease dementia patients underwent [18F]THK5317, carbon-11 Pittsburgh Compound-B ([11C]PIB), and 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography to assess the possible use of early-phase [18F]THK5317 and R1 as proxies for brain perfusion, and thus, for glucose metabolism. Discriminative performance (prodromal vs Alzheimer's disease dementia) of [18F]THK5317 (early-phase SUVr and R1) was compared with that of [11C]PIB (early-phase SUVr and R1) and [18F]FDG. Strong positive correlations were found between [18F]THK5317 (early-phase, R1) and [18F]FDG, particularly in frontal and temporoparietal regions. Differences in correlations between early-phase and R1 ([18F]THK5317 and [11C]PIB) and [18F]FDG, were not statistically significant, nor were differences in area under the curve values in the discriminative analysis. Our findings suggest that early-phase [18F]THK5317 and R1 provide information on brain perfusion, closely related to glucose metabolism. As such, a single positron emission tomography study with [18F]THK5317 may provide information about both tau pathology and brain perfusion in Alzheimer's disease, with potential clinical applications.
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Affiliation(s)
| | - Antoine Leuzy
- 1 Department NVS, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Anders Wall
- 2 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Agneta Nordberg
- 1 Department NVS, Karolinska Institutet, Stockholm, Sweden.,3 Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Daerr S, Brendel M, Zach C, Mille E, Schilling D, Zacherl MJ, Bürger K, Danek A, Pogarell O, Schildan A, Patt M, Barthel H, Sabri O, Bartenstein P, Rominger A. Evaluation of early-phase [ 18F]-florbetaben PET acquisition in clinical routine cases. Neuroimage Clin 2016; 14:77-86. [PMID: 28138429 PMCID: PMC5257027 DOI: 10.1016/j.nicl.2016.10.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/29/2016] [Accepted: 10/06/2016] [Indexed: 11/24/2022]
Abstract
Objectives In recent years several [18F]-labelled amyloid PET tracers have been developed and have obtained clinical approval. There is accumulating evidence that early (post injection) acquisitions with these tracers are equally informative as conventional blood flow and metabolism studies for diagnosis of Alzheimer's disease, but there have been few side-by-side studies. Therefore, we investigated the performance of early acquisitions of [18F]-florbetaben (FBB) PET compared to [18F]-fluorodeoxyglucose (FDG) PET in a clinical setting. Methods All subjects were recruited with clinical suspicion of dementia due to neurodegenerative disease. FDG PET was undertaken by conventional methods, and amyloid PET was performed with FBB, with early recordings for the initial 10 min (early-phase FBB), and late recordings at 90–110 min p.i. (late-phase FBB). Regional SUVR with cerebellar and global mean normalization were calculated for early-phase FBB and FDG PET. Pearson correlation coefficients between FDG and early-phase FBB were calculated for predefined cortical brain regions. Furthermore, a visual interpretation of disease pattern using 3-dimensional stereotactic surface projections (3D-SSP) was performed, with assessment of intra-reader agreement. Results Among a total of 33 patients (mean age 67.5 ± 11.0 years) included in the study, 18 were visually rated amyloid-positive, and 15 amyloid-negative based on late-phase FBB scans. Correlation coefficients for early-phase FBB vs. FDG scans displayed excellent agreement in all target brain regions for global mean normalization. Cerebellar normalization gave strong, but significantly lower correlations. 3D representations of early-phase FBB visually resembled the corresponding FDG PET images, irrespective of the amyloid-status of the late FBB scans. Conclusions Early-phase FBB acquisitions correlate on a relative quantitative and visual level with FDG PET scans, irrespective of the amyloid plaque density assessed in late FBB imaging. Thus, early-phase FBB uptake depicts a metabolism-like image, suggesting it as a valid surrogate marker for synaptic dysfunction, which could ultimately circumvent the need for additional FDG PET investigation in diagnosis of dementia. Early-phase [18F]-florbetaben uptake depicts a metabolism-like image Strong relative quantitative and visual correlations of early-phase [18F]-florbetaben uptake with FDG images A two-phase [18F]-florbetaben protocol might give combined neurodegeneration and amyloid pathology biomarker information Early-phase [18F]-florbetaben PET could ultimately circumvent the need for an additional FDG-PET in the dementia work-up.
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Key Words
- 3D-SSP, 3-dimensional stereotactic surface projections
- AD, Alzheimer's disease
- Alzheimer's disease
- CBF, cerebral blood flow
- CBL, cerebellum
- CN, cognitively normal
- FBB, [18F]florbetaben
- FDG Pet
- FDG, [18F]-fluorodeoxyglucose
- FTLD, frontotemporal lobar degeneration
- GLM, global mean
- L, left
- MCI, mild cognitive impairment
- MNI, Montreal Neurological Institute
- Metabolism
- PCC, posterior cingulate cortex
- PET, Positron emission tomography
- Perfusion
- R, right
- SPECT, single photon emission computed tomography
- SUVR, standardized uptake value ratio
- VOI, volume of interest
- [18F]-florbetaben PET
- p.i., post injection
- ß-amyloid
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Affiliation(s)
- Sonja Daerr
- Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany
| | - Matthias Brendel
- Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany
| | - Christian Zach
- Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany
| | - Erik Mille
- Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany
| | - Dorothee Schilling
- Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany
| | | | - Katharina Bürger
- ISD, Ludwig-Maximilians-Universität München, München, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Adrian Danek
- Dept. of Neurology, Ludwig-Maximilians-Universität München, München, Germany
| | - Oliver Pogarell
- Dept. of Psychiatry, Ludwig-Maximilians-Universität München, München, Germany
| | - Andreas Schildan
- Dept. of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Marianne Patt
- Dept. of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Dept. of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Dept. of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Peter Bartenstein
- Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany; SyNergy, Ludwig-Maximilians-Universität München, München, Germany
| | - Axel Rominger
- Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany; SyNergy, Ludwig-Maximilians-Universität München, München, Germany
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Valentina G, Silvia M, Marco P. Dual-phase amyloid PET: hitting two birds with one stone. Eur J Nucl Med Mol Imaging 2016; 43:1300-3. [DOI: 10.1007/s00259-016-3393-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 04/08/2016] [Indexed: 10/21/2022]
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Tiepolt S, Hesse S, Patt M, Luthardt J, Schroeter ML, Hoffmann K, Weise D, Gertz H, Sabri O, Barthel H. Early [18F]florbetaben and [11C]PiB PET images are a surrogate biomarker of neuronal injury in Alzheimer’s disease. Eur J Nucl Med Mol Imaging 2016; 43:1700-9. [PMID: 27026271 DOI: 10.1007/s00259-016-3353-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/21/2016] [Indexed: 10/22/2022]
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Rodriguez-Vieitez E, Carter SF, Chiotis K, Saint-Aubert L, Leuzy A, Schöll M, Almkvist O, Wall A, Långström B, Nordberg A. Comparison of Early-Phase 11C-Deuterium-l-Deprenyl and 11C-Pittsburgh Compound B PET for Assessing Brain Perfusion in Alzheimer Disease. J Nucl Med 2016; 57:1071-7. [PMID: 26912447 DOI: 10.2967/jnumed.115.168732] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/29/2016] [Indexed: 01/07/2023] Open
Abstract
UNLABELLED The PET tracer (11)C-deuterium-L-deprenyl ((11)C-DED) has been used to visualize activated astrocytes in vivo in patients with Alzheimer disease (AD). In this multitracer PET study, early-phase (11)C-DED and (11)C-Pittsburgh compound B ((11)C-PiB) (eDED and ePiB, respectively) were compared as surrogate markers of brain perfusion, and the extent to which (11)C-DED binding is influenced by brain perfusion was investigated. METHODS (11)C-DED, (11)C-PiB, and (18)F-FDG dynamic PET scans were obtained in age-matched groups comprising AD patients (n = 8), patients with mild cognitive impairment (n = 17), and healthy controls (n = 16). A modified reference Patlak model was used to quantify (11)C-DED binding. A simplified reference tissue model was applied to both (11)C-DED and (11)C-PiB to measure brain perfusion relative to the cerebellar gray matter (R1) and binding potentials. (11)C-PiB retention and (18)F-FDG uptake were also quantified as target-to-pons SUV ratios in 12 regions of interest (ROIs). RESULTS The strongest within-subject correlations with the corresponding R1 values (R1,DED and R1,PiB, respectively) and with (18)F-FDG uptake were obtained when the eDED and ePiB PET data were measured 1-4 min after injection. The optimum eDED/ePiB intervals also showed strong, significant ROI-based intersubject Pearson correlations with R1,DED/R1,PiB and with (18)F-FDG uptake, whereas (11)C-DED binding was largely independent of brain perfusion, as measured by eDED. Corresponding voxelwise correlations confirmed the ROI-based results. Temporoparietal eDED or ePiB brain perfusion measurements were highly discriminative between patient and control groups, with discriminative ability statistically comparable to that of temporoparietal (18)F-FDG glucose metabolism. Hypometabolism extended over wider regions than hypoperfusion in patient groups compared with controls. CONCLUSION The 1- to 4-min early-frame intervals of (11)C-DED or (11)C-PiB are suitable surrogate measures for brain perfusion. (11)C-DED binding is independent of brain perfusion, and thus (11)C-DED PET can provide information on both functional (brain perfusion) and pathologic (astrocytosis) aspects from a single PET scan. In comparison with glucose metabolism, early-phase (11)C-DED and (11)C-PiB perfusion appear to provide complementary rather than redundant information.
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Affiliation(s)
- Elena Rodriguez-Vieitez
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Stephen F Carter
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Wolfson Molecular Imaging Centre, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Konstantinos Chiotis
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Laure Saint-Aubert
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Antoine Leuzy
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Michael Schöll
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ove Almkvist
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Psychology, Stockholm University, Stockholm, Sweden Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Anders Wall
- Department of Surgical Sciences, Section of Nuclear Medicine & PET, Uppsala University, Uppsala, Sweden; and
| | | | - Agneta Nordberg
- Division of Translational Alzheimer Neurobiology, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Abstract
The complexity of the pathological reactions of the brain to an aggression caused
by an internal or external noxa represents a challenge for molecular imaging.
Positron emission tomography (PET) can indicate in vivo,
anatomopathological changes involved in the development of different clinical
symptoms in patients with neurodegenerative disorders. PET and the multitracer
concept can provide information from different systems in the brain tissue
building an image of the whole disease. We present here the combination of
18F-flourodeoxyglucose (FDG) and
N-[11C-methyl]-L-deuterodeprenyl (DED), FDG and
N-[11C-methyl] 2-(4'-methylaminophenyl)-6-hydroxybenzothiazole (PIB),
PIB and L-[11C]-3'4-Dihydrophenylalanine (DOPA) and finally PIB and
[15O]H2O.
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Affiliation(s)
- Henry Engler
- MD. PhD - Uruguayan Centre of Molecular Imaging (CUDIM), Montevideo, Uruguay
| | - Andres Damian
- MD - Uruguayan Centre of Molecular Imaging (CUDIM), Montevideo, Uruguay
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Chen YJ, Rosario BL, Mowrey W, Laymon CM, Lu X, Lopez OL, Klunk WE, Lopresti BJ, Mathis CA, Price JC. Relative 11C-PiB Delivery as a Proxy of Relative CBF: Quantitative Evaluation Using Single-Session 15O-Water and 11C-PiB PET. J Nucl Med 2015; 56:1199-205. [PMID: 26045309 DOI: 10.2967/jnumed.114.152405] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 05/24/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The primary goal of this study was to assess the suitability of (11)C-Pittsburgh compound B ((11)C-PiB) blood-brain barrier delivery (K1) and relative delivery (R1) parameters as surrogate indices of cerebral blood flow (CBF), with a secondary goal of directly examining the extent to which simplified uptake measures of (11)C-PiB retention (amyloid-β load) may be influenced by CBF, in a cohort of controls and patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). METHODS Nineteen participants (6 controls, 5 AD, 8 MCI) underwent MR imaging, (15)O-water PET, and (11)C-PiB PET in a single session. Fourteen regions of interest (including cerebellar reference region) were defined on MR imaging and applied to dynamic coregistered PET to generate time-activity curves. Multiple analysis approaches provided regional (15)O-water and (11)C-PiB measures of delivery and (11)C-PiB retention that included compartmental modeling distribution volume ratio (DVR), arterial- and reference-based Logan DVR, simplified reference tissue modeling 2 (SRTM2) DVR, and standardized uptake value ratios. Spearman correlation was performed among delivery measures (i.e., (15)O-water K1 and (11)C-PiB K1, relative K1 normalized to cerebellum [Rel-K1-Water and Rel-K1-PiB], and (11)C-PiB SRTM2-R1) and between delivery measures and (11)C-PiB retention, using the Bonferroni method for multiple-comparison correction. RESULTS Primary analysis showed positive correlations (ρ ≈0.2-0.5) between (15)O-water K1 and (11)C-PiB K1 that did not survive Bonferroni adjustment. Significant positive correlations were found between Rel-K1-Water and Rel-K1-PiB and between Rel-K1-Water and (11)C-PiB SRTM2-R1 (ρ ≈0.5-0.8, P < 0.0036) across primary cortical regions. Secondary analysis showed few significant correlations between (11)C-PiB retention and relative (11)C-PiB delivery measures (but not (15)O-water delivery measures) in primary cortical areas that arose only after accounting for cerebrospinal fluid dilution. CONCLUSION (11)C-PiB SRTM2-R1 is highly correlated with regional relative CBF, as measured by (15)O-water K1 normalized to cerebellum, and cross-sectional (11)C-PiB retention did not strongly depend on CBF across primary cortical regions. These results provide further support for potential dual-imaging assessments of regional brain status (i.e., amyloid-β load and relative CBF) through dynamic (11)C-PiB imaging.
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Affiliation(s)
- Yin J Chen
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Bedda L Rosario
- Department of Biostatistics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Wenzhu Mowrey
- Department of Biostatistics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Charles M Laymon
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Xueling Lu
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Brian J Lopresti
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Chester A Mathis
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Julie C Price
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Sojkova J, Goh J, Bilgel M, Landman B, Yang X, Zhou Y, An Y, Beason-Held LL, Kraut MA, Wong DF, Resnick SM. Voxelwise Relationships Between Distribution Volume Ratio and Cerebral Blood Flow: Implications for Analysis of β-Amyloid Images. J Nucl Med 2015; 56:1042-7. [PMID: 25977462 DOI: 10.2967/jnumed.114.151480] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/15/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Quantification of β-amyloid (Aβ) in vivo is often accomplished using the distribution volume ratio (DVR), based on a simplified reference tissue model. We investigated the local relationships between DVR and cerebral blood flow (CBF), as well as relative CBF (R1), in nondemented older adults. METHODS Fifty-five nondemented participants (mean age, 78.5 y) in the Baltimore Longitudinal Study of Aging underwent (15)O-H2O PET CBF and dynamic (11)C-PiB PET. (15)O-H2O PET images were normalized and smoothed using SPM. A simplified reference tissue model with linear regression and spatial constraints was used to generate parametric DVR images. The DVR images were regressed on CBF images on a voxel-by-voxel basis using robust biologic parametric mapping, adjusting for age and sex (false discovery rate, P = 0.05; spatial extent, 50 voxels). DVR images were also regressed on R1 images, a measure of the transport rate constant from vascular space to tissue. All analyses were performed on the entire sample, and on high and low tertiles of mean cortical DVR. RESULTS Voxel-based analyses showed that increased DVR is associated with increased CBF in the frontal, parietal, temporal, and occipital cortices. However, this association appears to spare regions that typically show early Aβ deposition. A more robust relationship between DVR and CBF was observed in the lower tertile of DVR, that is, negligible cortical Aβ load, compared with the upper tertile of cortical DVR and Aβ load. The spatial distributions of the DVR-CBF and DVR-R1 correlations showed similar patterns. No reliable negative voxelwise relationships between DVR and CBF or R1 were observed. CONCLUSION Robust associations between DVR and CBF at negligible Aβ levels, together with similar spatial distributions of DVR-CBF and DVR-R1 correlations, suggest that regional distribution of DVR reflects blood flow and tracer influx rather than pattern of Aβ deposition in those with minimal Aβ load. DVR-CBF associations in individuals with a higher DVR are more likely to reflect true associations between patterns of Aβ deposition and CBF or neural activity. These findings have important implications for analysis and interpretation of voxelwise correlations with external variables in individuals with varying amounts of Aβ load.
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Affiliation(s)
- Jitka Sojkova
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Bethesda, Maryland
| | - Joshua Goh
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Bethesda, Maryland National Taiwan University, Taipei, Taiwan
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Bethesda, Maryland Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Bennett Landman
- Department of Electrical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Xue Yang
- Department of Electrical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Yun Zhou
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Bethesda, Maryland
| | - Lori L Beason-Held
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Bethesda, Maryland
| | - Michael A Kraut
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Dean F Wong
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland Solomon Snyder Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland; and Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Bethesda, Maryland
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Gietl AF, Warnock G, Riese F, Kälin AM, Saake A, Gruber E, Leh SE, Unschuld PG, Kuhn FP, Burger C, Mu L, Seifert B, Nitsch RM, Schibli R, Ametamey SM, Buck A, Hock C. Regional cerebral blood flow estimated by early PiB uptake is reduced in mild cognitive impairment and associated with age in an amyloid-dependent manner. Neurobiol Aging 2015; 36:1619-28. [PMID: 25702957 DOI: 10.1016/j.neurobiolaging.2014.12.036] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 12/22/2014] [Accepted: 12/26/2014] [Indexed: 12/16/2022]
Abstract
Early uptake of [(11)C]-Pittsburgh Compound B (ePiB, 0-6 minutes) estimates cerebral blood flow. We studied ePiB in 13 PiB-negative and 10 PiB-positive subjects with mild cognitive impairment (MCI, n = 23) and 11 PiB-positive and 74 PiB-negative cognitively healthy elderly control subjects (HCS, n = 85) in 6 bilateral volumes of interest: posterior cingulate cortex (PCC), hippocampus (hipp), temporoparietal region, superior parietal gyrus, parahippocampal gyrus (parahipp), and inferior frontal gyrus (IFG) for the associations with cognitive status, age, amyloid deposition, and apolipoprotein E ε4-allele. We observed no difference in ePiB between PiB-positive and -negative subjects and carriers and noncarriers. EPiB decreased with age in PiB-positive subjects in bilateral superior parietal gyrus, bilateral temporoparietal region, right IFG, right PCC, and left parahippocampal gyrus but not in PiB-negative subjects. MCI had lower ePiB than HCS (left PCC, left IFG, and left and right hipp). Lowest ePiB values were found in MCI of 70 years and older, who also displayed high cortical PiB binding. This suggests that lowered regional cerebral blood flow indicated by ePiB is associated with age in the presence but not in the absence of amyloid pathology.
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Schmidt ME, Chiao P, Klein G, Matthews D, Thurfjell L, Cole PE, Margolin R, Landau S, Foster NL, Mason NS, De Santi S, Suhy J, Koeppe RA, Jagust W. The influence of biological and technical factors on quantitative analysis of amyloid PET: Points to consider and recommendations for controlling variability in longitudinal data. Alzheimers Dement 2014; 11:1050-68. [PMID: 25457431 DOI: 10.1016/j.jalz.2014.09.004] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 08/05/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
Abstract
In vivo imaging of amyloid burden with positron emission tomography (PET) provides a means for studying the pathophysiology of Alzheimer's and related diseases. Measurement of subtle changes in amyloid burden requires quantitative analysis of image data. Reliable quantitative analysis of amyloid PET scans acquired at multiple sites and over time requires rigorous standardization of acquisition protocols, subject management, tracer administration, image quality control, and image processing and analysis methods. We review critical points in the acquisition and analysis of amyloid PET, identify ways in which technical factors can contribute to measurement variability, and suggest methods for mitigating these sources of noise. Improved quantitative accuracy could reduce the sample size necessary to detect intervention effects when amyloid PET is used as a treatment end point and allow more reliable interpretation of change in amyloid burden and its relationship to clinical course.
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Affiliation(s)
| | | | | | | | | | | | | | - Susan Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Norman L Foster
- Division of Cognitive Neurology, University of Utah, Salt Lake City, UT, USA
| | - N Scott Mason
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Robert A Koeppe
- Division of Nuclear Medicine, University of Michigan, Ann Arbor, MI, USA
| | - William Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
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Fu L, Liu L, Zhang J, Xu B, Fan Y, Tian J. Comparison of dual-biomarker PIB-PET and dual-tracer PET in AD diagnosis. Eur Radiol 2014; 24:2800-9. [PMID: 25097125 DOI: 10.1007/s00330-014-3311-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 06/10/2014] [Accepted: 07/03/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To identify the optimal time window for capturing perfusion information from early (11)C-PIB imaging frames (perfusion PIB, (11)C-pPIB) and to compare the performance of (18)F-FDG PET and "dual biomarker" (11)C-PIB PET [(11)C-pPIB and amyloid PIB ((11)C-aPIB)] for classification of AD, MCI and CN subjects. METHODS Forty subjects (14 CN, 12 MCI and 14 AD patients) underwent (18)F-FDG and (11)C-PIB PET studies. Pearson correlation between the (18)F-FDG image and sum of early (11)C-PIB frames was maximised to identify the optimal time window for (11)C-pPIB. The classification power of imaging parameters was evaluated with a leave-one-out validation. RESULTS A 7-min time window yielded the highest correlation between (18)F-FDG and (11)C-pPIB. (11)C-pPIB and (18)F-FDG images shared a similar radioactive distribution pattern. (18)F-FDG performed better than (11)C-pPIB for the classification of both AD vs. CN and MCI vs. CN. (11)C-pPIB + (11)C-aPIB and (18)F-FDG + (11)C-aPIB yielded the highest classification accuracy for the classification of AD vs. CN, and (18)F-FDG + (11)C-aPIB had the best classification performance for the classification of MCI vs. CN CONCLUSION C-pPIB could serve as a useful biomarker of rCBF for measuring neural activity and improve the diagnostic power of PET for AD in conjunction with (11)C-aPIB. (18)F-FDG and (11)C-PIB dual-tracer PET examination could better detect MCI. KEY POINTS • Dual-tracer PET examination provides neurofunctional and neuropathological information for AD diagnosis. • The identified optimal 11C-pPIB time frames had highest correlation with 18F-FDG. • 11C-pPIB images shared a similar radioactive distribution pattern with 18F-FDG images. • 11C-pPIB can provide neurofunctional information. • Dual-tracer PET examination could better detect MCI.
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Affiliation(s)
- Liping Fu
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Fuxing Rd., 28, Beijing, China
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Kaneta T, Okamura N, Arai A, Takanami K, Furukawa K, Tashiro M, Furumoto S, Iwata R, Takahashi S, Arai H, Yanai K, Kudo Y. Analysis of early phase [11C]BF-227 PET, and its application for anatomical standardization of late-phase images for 3D-SSP analysis. Jpn J Radiol 2014; 32:138-44. [DOI: 10.1007/s11604-013-0276-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 12/22/2013] [Indexed: 10/25/2022]
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Fast R, Rodell A, Gjedde A, Mouridsen K, Alstrup AK, Bjarkam CR, West MJ, Berendt M, Møller A. PiB Fails to Map Amyloid Deposits in Cerebral Cortex of Aged Dogs with Canine Cognitive Dysfunction. Front Aging Neurosci 2013; 5:99. [PMID: 24416017 PMCID: PMC3874561 DOI: 10.3389/fnagi.2013.00099] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 12/10/2013] [Indexed: 11/25/2022] Open
Abstract
Dogs with Canine Cognitive Dysfunction (CCD) accumulate amyloid beta (Aβ) in the brain. As the cognitive decline and neuropathology of these old dogs share features with Alzheimer’s disease (AD), the relation between Aβ and cognitive decline in animal models of cognitive decline is of interest to the understanding of AD. However, the sensitivity of the biomarker Pittsburgh Compound B (PiB) to the presence of Aβ in humans and in other mammalian species is in doubt. To test the sensitivity and assess the distribution of Aβ in dog brain, we mapped the brains of dogs with signs of CCD (n = 16) and a control group (n = 4) of healthy dogs with radioactively labeled PiB ([11C]PiB). Structural magnetic resonance imaging brain scans were obtained from each dog. Tracer washout analysis yielded parametric maps of PiB retention in brain. In the CCD group, dogs had significant retention of [11C]PiB in the cerebellum, compared to the cerebral cortex. Retention in the cerebellum is at variance with evidence from brains of humans with AD. To confirm the lack of sensitivity, we stained two dog brains with the immunohistochemical marker 6E10, which is sensitive to the presence of both Aβ and Aβ precursor protein (AβPP). The 6E10 stain revealed intracellular material positive for Aβ or AβPP, or both, in Purkinje cells. The brains of the two groups of dogs did not have significantly different patterns of [11C]PiB binding, suggesting that the material detected with 6E10 is AβPP rather than Aβ. As the comparison with the histological images revealed no correlation between the [11C]PiB and Aβ and AβPP deposits in post-mortem brain, the marked intracellular staining implies intracellular involvement of amyloid processing in the dog brain. We conclude that PET maps of [11C]PiB retention in brain of dogs with CCD fundamentally differ from the images obtained in most humans with AD.
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Affiliation(s)
- Rikke Fast
- Department of Clinical Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Frederiksberg , Denmark
| | - Anders Rodell
- Centre of Functionally Integrative Neuroscience (CFIN), Aarhus University , Aarhus , Denmark ; Department of Nuclear Medicine and PET Center, Aarhus University Hospital , Aarhus , Denmark
| | - Albert Gjedde
- Centre of Functionally Integrative Neuroscience (CFIN), Aarhus University , Aarhus , Denmark ; Department of Nuclear Medicine and PET Center, Aarhus University Hospital , Aarhus , Denmark ; Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Kim Mouridsen
- Centre of Functionally Integrative Neuroscience (CFIN), Aarhus University , Aarhus , Denmark
| | - Aage K Alstrup
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital , Aarhus , Denmark
| | - Carsten R Bjarkam
- Department of Biomedicine, Faculty of Health, University of Aarhus , Aarhus , Denmark ; Department of Neurosurgery, Aarhus University Hospital , Aarhus , Denmark
| | - Mark J West
- Department of Biomedicine, Faculty of Health, University of Aarhus , Aarhus , Denmark
| | - Mette Berendt
- Department of Clinical Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Frederiksberg , Denmark
| | - Arne Møller
- Centre of Functionally Integrative Neuroscience (CFIN), Aarhus University , Aarhus , Denmark ; Department of Nuclear Medicine and PET Center, Aarhus University Hospital , Aarhus , Denmark
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Sato K, Fukushi K, Shinotoh H, Shimada H, Hirano S, Tanaka N, Suhara T, Irie T, Ito H. Noninvasive k3 estimation method for slow dissociation PET ligands: application to [11C]Pittsburgh compound B. EJNMMI Res 2013; 3:76. [PMID: 24238306 PMCID: PMC3834104 DOI: 10.1186/2191-219x-3-76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/06/2013] [Indexed: 11/24/2022] Open
Abstract
Background Recently, we reported an information density theory and an analysis of three-parameter plus shorter scan than conventional method (3P+) for the amyloid-binding ligand [11C]Pittsburgh compound B (PIB) as an example of a non-highly reversible positron emission tomography (PET) ligand. This article describes an extension of 3P + analysis to noninvasive ‘3P++’ analysis (3P + plus use of a reference tissue for input function). Methods In 3P++ analysis for [11C]PIB, the cerebellum was used as a reference tissue (negligible specific binding). Fifteen healthy subjects (NC) and fifteen Alzheimer's disease (AD) patients participated. The k3 (index of receptor density) values were estimated with 40-min PET data and three-parameter reference tissue model and were compared with that in 40-min 3P + analysis as well as standard 90-min four-parameter (4P) analysis with arterial input function. Simulation studies were performed to explain k3 biases observed in 3P++ analysis. Results Good model fits of 40-min PET data were observed in both reference and target regions-of-interest (ROIs). High linear intra-subject (inter-15 ROI) correlations of k3 between 3P++ (Y-axis) and 3P + (X-axis) analyses were shown in one NC (r2 = 0.972 and slope = 0.845) and in one AD (r2 = 0.982, slope = 0.655), whereas inter-subject k3 correlations in a target region (left lateral temporal cortex) from 30 subjects (15 NC + 15 AD) were somewhat lower (r2 = 0.739 and slope = 0.461). Similar results were shown between 3P++ and 4P analyses: r2 = 0.953 for intra-subject k3 in NC, r2 = 0.907 for that in AD and r2 = 0.711 for inter-30 subject k3. Simulation studies showed that such lower inter-subject k3 correlations and significant negative k3 biases were not due to unstableness of 3P++ analysis but rather to inter-subject variation of both k2 (index of brain-to-blood transport) and k3 (not completely negligible) in the reference region. Conclusions In [11C]PIB, the applicability of 3P++ analysis may be restricted to intra-subject comparison such as follow-up studies. The 3P++ method itself is thought to be robust and may be more applicable to other non-highly reversible PET ligands with ideal reference tissue.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Hiroshi Ito
- Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 260-8555, Japan.
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Abstract
In the labeled form, the Pittsburgh compound B (2-(4′-{N-methyl-[11C]}methyl-aminophenyl)-6-hydroxy-benzothiazole, [11C]PiB), is used as a biomarker for positron emission tomography (PET) of brain β-amyloid deposition in Alzheimer's disease (AD). The permeability of [11C]PiB in the blood-brain barrier is held to be high but the permeability-surface area product and extraction fractions in patients or healthy volunteers are not known. We used PET to determine the clearance associated with the unidrectional blood-brain transfer of [11C]PiB and the corresponding cerebral blood flow rates in frontal lobe, whole cerebral cortex, and cerebellum of patients with Alzheimer's disease and healthy volunteers. Regional cerebral blood flow rates differed significantly between the two groups. Thus, regional and whole-brain permeability-surface area products were identical, in agreement with the observation that numerically, but insignificantly, unidirectional blood-brain clearances are lower and extraction fractions higher in the patients. The evidence of unchanged permeability-surface area products in the patients implies that blood flow changes can be deduced from the unidirectional blood-brain clearances of [11C]PiB in the patients.
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Affiliation(s)
- Albert Gjedde
- Department of Neuroscience and Pharmacology, University of Copenhagen Copenhagen, Denmark ; Department of Nuclear Medicine and PET Centre, Aarhus University Hospital Aarhus, Denmark ; Center of Functionally Integrative Neuroscience, Faculty of Health, Aarhus University Aarhus, Denmark ; Department of Neurology, McGill University Montreal, QC, Canada ; Department of Radiology and Radiological Science, Johns Hopkins University Baltimore, MD, USA
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Forsberg A, Engler H, Blomquist G, Långström B, Nordberg A. The use of PIB-PET as a dual pathological and functional biomarker in AD. Biochim Biophys Acta Mol Basis Dis 2012; 1822:380-5. [PMID: 22115832 DOI: 10.1016/j.bbadis.2011.11.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 11/05/2011] [Accepted: 11/07/2011] [Indexed: 10/15/2022]
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Sato K, Fukushi K, Shinotoh H, Shimada H, Tanaka N, Hirano S, Irie T. A short-scan method for k(3) estimation with moderately reversible PET ligands: application of irreversible model to early-phase PET data. Neuroimage 2012; 59:3149-58. [PMID: 22079452 DOI: 10.1016/j.neuroimage.2011.10.087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 10/08/2011] [Accepted: 10/25/2011] [Indexed: 10/15/2022] Open
Abstract
Long dynamic scans (60-120 min) are often required for estimating the k(3) value, an index of receptor density, by positron emission tomography (PET). However, the precision of k(3) is usually low in kinetic analyses for reversible PET ligands compared with irreversible ligands. That is largely due to unstable estimation of the dissociation rate constant, k(4). We propose a novel '3P+' method for estimating k(3) of moderately reversible ligands, where a 3-parameter model without k(4) is applied to early-phase PET data to obtain a good model-fit of k(3) estimation. By using [(11)C] Pittsburgh compound B (PIB) (k(4) = 0.018/min) as an example of a moderately reversible ligand, the 3P+ method simulation with a 28 min PET scan yielded less than 3% k(3) relative bias with a +100% k(3) change. In [(11)C]PIB PET scans of 15 normal controls (NC) and nine patients with Alzheimer's disease (AD), the 3P+ method provided a precise k(3) estimate (mean SE of 13.6% in parietal cortex; covariance matrix method). The results revealed linear correlations (r = 0.964) of parietal k(3) values in 24 subjects between 28minute 3P+ method and conventional 90 minute 4-parameter method. A good separation of k(3) between NC and AD groups (P < 0.001; t-test) was replicated in 28 minute 3P+ method. The short-scan 3P+ method may be a practical alternative method for analyzing reversible ligands.
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Affiliation(s)
- Koichi Sato
- Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 260-8555, Japan.
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Cselényi Z, Jönhagen ME, Forsberg A, Halldin C, Julin P, Schou M, Johnström P, Varnäs K, Svensson S, Farde L. Clinical Validation of 18F-AZD4694, an Amyloid-β–Specific PET Radioligand. J Nucl Med 2012; 53:415-24. [DOI: 10.2967/jnumed.111.094029] [Citation(s) in RCA: 175] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hsiao I, Huang C, Hsieh C, Hsu W, Wey S, Yen T, Kung M, Lin K. Correlation of early-phase 18F-florbetapir (AV-45/Amyvid) PET images to FDG images: preliminary studies. Eur J Nucl Med Mol Imaging 2012; 39:613-20. [DOI: 10.1007/s00259-011-2051-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 12/27/2011] [Indexed: 10/14/2022]
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Schafer KN, Kim S, Matzavinos A, Kuret J. Selectivity requirements for diagnostic imaging of neurofibrillary lesions in Alzheimer's disease: a simulation study. Neuroimage 2012; 60:1724-33. [PMID: 22273569 DOI: 10.1016/j.neuroimage.2012.01.066] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 12/23/2011] [Accepted: 01/08/2012] [Indexed: 10/14/2022] Open
Abstract
Whole-brain imaging is a promising strategy for premortem detection of tau-bearing neurofibrillary lesions that accumulate in Alzheimer's disease. However, the approach is complicated by the high concentrations of potentially confounding binding sites presented by beta-amyloid plaques. To predict the contributions of relative binding affinity and binding site density to the imaging-dynamics and selectivity of a hypothetical tau-directed radiotracer, a nonlinear, four-tissue compartment pharmacokinetic model of diffusion-mediated radiotracer uptake and distribution was developed. Initial estimates of nonspecific binding and brain uptake parameters were made by fitting data from a previously published kinetic study of Pittsburgh Compound B, an established amyloid-directed radiotracer. The resulting estimates were then used to guide simulations of tau binding selectivity while assuming early-stage accumulation of disease pathology. The simulations suggest that for tau aggregates to represent at least 80% of specific binding signal, binding affinity or density selectivities for tau over beta-amyloid should be at least 20- or 50-fold, respectively. The simulations also suggest, however, that overcoming nonspecific binding will be an additional challenge for tau-directed radiotracers owing to low concentrations of available binding sites. Overall, nonlinear modeling can provide insight into the performance characteristics needed for tau-directed radiotracers in vivo.
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Affiliation(s)
- Kelsey N Schafer
- Department of Molecular and Cellular Biochemistry, The Ohio State University College of Medicine, Columbus, Ohio 43210, USA
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Moghbel MC, Saboury B, Basu S, Metzler SD, Torigian DA, Långström B, Alavi A. Amyloid-β imaging with PET in Alzheimer’s disease: is it feasible with current radiotracers and technologies? Eur J Nucl Med Mol Imaging 2011; 39:202-8. [DOI: 10.1007/s00259-011-1960-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
[11C]Pittsburgh Compound B positron emission tomography has now been extensively used to evaluate the amyloid load in different types of dementia and has become a powerful research tool in the field of neurodegenerative diseases. In the present short review we discuss the properties of amyloid imaging agent [11C]Pittsburgh Compound B, the different modalities of molecular imaging, image processing and data analysis, and newer amyloid imaging agents.
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Affiliation(s)
- Paul Edison
- Medical Research Council Clinical Sciences Centre and Division of Neuroscience, Imperial College London, Cyclotron Building, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
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Santillo AF, Gambini JP, Lannfelt L, Långström B, Ulla-marja L, Kilander L, Engler H. In vivo imaging of astrocytosis in Alzheimer’s disease: an 11C-L-deuteriodeprenyl and PIB PET study. Eur J Nucl Med Mol Imaging 2011; 38:2202-8. [DOI: 10.1007/s00259-011-1895-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 07/25/2011] [Indexed: 11/27/2022]
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Meyer PT, Hellwig S, Amtage F, Rottenburger C, Sahm U, Reuland P, Weber WA, Hüll M. Dual-biomarker imaging of regional cerebral amyloid load and neuronal activity in dementia with PET and 11C-labeled Pittsburgh compound B. J Nucl Med 2011; 52:393-400. [PMID: 21321269 DOI: 10.2967/jnumed.110.083683] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED PET studies with biomarkers of regional neuronal activity (cerebral glucose metabolism or blood flow [CBF]) and amyloid-β (Aβ) depositions provide complementary information for the early diagnosis of dementia and follow-up of patients with dementia. We investigated the validity of relative regional CBF estimates (R(1)) gained from pharmacokinetic analyses of (11)C-labeled Pittsburgh compound B ((11)C-PIB) PET studies as a marker of neuronal activity and neurodegeneration. METHODS Twenty-two patients with cognitive impairment (16 patients with early Alzheimer disease) underwent (18)F-FDG and (11)C-PIB PET studies for the assessment of regional glucose metabolism and Aβ load. Parametric images of R(1) (relative CBF) and binding potential (BP(ND); Aβ load) were generated by 2-step simplified reference tissue model (SRTM2) analyses of dynamic (11)C-PIB data. Volume-of-interest and voxel-based statistical analyses were performed to investigate the association between normalized (18)F-FDG uptake and (11)C-PIB R(1) and the correlation of these measures with symptom severity (Mini-Mental State Examination [MMSE] scores) in patients with Alzheimer disease. RESULTS SRTM2 analyses provided high-quality (11)C-PIB R(1) images that were comparable to (18)F-FDG PET images. Regional (11)C-PIB R(1) values strongly correlated with normalized regional (18)F-FDG uptake when correlations were calculated separately for each patient (R(2) [mean ± SD], 0.73 ± 0.11) or across all regions of all patients (R(2), 0.62). A regression model including (18)F-FDG uptake, subject identification, and region grouping (into cortical, subcortical, and limbic regions to allow for possible differences in flow/metabolism coupling) accounted for 86% of total (11)C-PIB R(1) variability. Voxel-based correlation analyses of (18)F-FDG uptake and (11)C-PIB R(1) with MMSE scores revealed similar core findings of positive correlations in the posterior cingulate gyrus/precuneus and negative correlations (preserved activity) in the bilateral sensorimotor cortex. There was no correlation between Aβ load (BP(ND)) and MMSE scores. CONCLUSION These results strongly suggest that (11)C-PIB R(1) can serve as a complementary biomarker of neuronal activity and, thus, neurodegeneration in addition to Aβ load given by (11)C-PIB BP(ND). Further studies are needed to validate the diagnostic value of dual-biomarker (11)C-PIB PET studies in comparison with combined (18)F-FDG and (11)C-PIB PET studies. Compared with the latter, dual-biomarker (11)C-PIB PET greatly reduces costs and burden for patients.
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Affiliation(s)
- Philipp T Meyer
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany.
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Rostomian AH, Madison C, Rabinovici GD, Jagust WJ. Early 11C-PIB frames and 18F-FDG PET measures are comparable: a study validated in a cohort of AD and FTLD patients. J Nucl Med 2011; 52:173-9. [PMID: 21233181 DOI: 10.2967/jnumed.110.082057] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The availability of new PET ligands offers the potential to measure fibrillar β-amyloid in the brain. Nevertheless, physiologic information in the form of perfusion or metabolism may still be useful in differentiating causes of dementia during life. In this study, we investigated whether early (11)C-Pittsburgh compound B ((11)C-PIB) PET frames (perfusion (11)C-PIB [pPIB]) could provide information equivalent to blood flow and metabolism. First, we assessed the similarity of pPIB and (18)F-FDG PET images in a test cohort with various clinical diagnoses (n = 10), and then we validated the results in a cohort of patients with Alzheimer disease (AD) (n = 42; mean age ± SD, 66.6 ± 10.6 y; mean Mini-Mental State Examination [MMSE] score ± SD, 22.2 ± 6.0) or frontotemporal lobar degeneration (FTLD) (n = 31; age ± SD, 63.9 ± 7.1 y, mean MMSE score ± SD, 23.8 ± 6.7). METHODS To identify the (11)C-PIB frames best representing perfusion, we ran on a test cohort an iterative algorithm, including generating normalized (cerebellar reference) perfusion pPIB images across variable frame ranges and calculating Pearson R values of the sum of these pPIB frames with the sum of all (18)F-FDG frames (cerebellar normalized) for all brain tissue voxels. Once this perfusion frame range was determined on the test cohort, it was then validated on an extended cohort and the power of pPIB in differential diagnosis was compared with (18)F-FDG by performing a logistic regression of regions-of-interest tracer measure (pPIB or (18)F-FDG) versus diagnosis. RESULTS A 7-min window, corresponding to minutes 1-8 (frames 5-15), produced the highest voxelwise correlation between (18)F-FDG and pPIB (R = 0.78 ± 0.05). This pPIB frame range was further validated on the extended AD and FTLD cohort across 12 regions of interest (R = 0.91 ± 0.09). A logistic model using pPIB was able to classify 90.5% of the AD and 83.9% of the FTLD patients correctly. Using (18)F-FDG, we correctly classified 88.1% of AD and 83.9% of FTLD patients. The temporal pole and temporal neocortex were significant discriminators (P < 0.05) in both models, whereas in the model with pPIB the frontal region was also significant. CONCLUSION The high correlation between pPIB and (18)F-FDG measures and their comparable performance in differential diagnosis are promising in providing functional information using (11)C-PIB PET data. This approach could be useful, obviating (18)F-FDG scans when longer-lived amyloid imaging agents become available.
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Affiliation(s)
- Ara H Rostomian
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California 94720, USA
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Zhou Y, Ye W, Brasić JR, Wong DF. Multi-graphical analysis of dynamic PET. Neuroimage 2010; 49:2947-57. [PMID: 19931403 DOI: 10.1016/j.neuroimage.2009.11.028] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Revised: 11/01/2009] [Accepted: 11/11/2009] [Indexed: 11/22/2022] Open
Abstract
In quantitative dynamic PET studies, graphical analysis methods including the Gjedde-Patlak plot, the Logan plot, and the relative equilibrium-based graphical plot (RE plot) (Zhou Y., Ye W., Brasić J.R., Crabb A.H., Hilton J., Wong D.F. 2009b. A consistent and efficient graphical analysis method to improve the quantification of reversible tracer binding in radioligand receptor dynamic PET studies. Neuroimage 44(3):661-670) are based on the theory of a compartmental model with assumptions on tissue tracer kinetics. If those assumptions are violated, then the resulting estimates may be biased. In this study, a multi-graphical analysis method was developed to characterize the non-relative equilibrium effects on the estimates of total distribution volume (DV(T)) from the RE plot. A novel bi-graphical analysis method using the RE plot with the Gjedde-Patlak plot (RE-GP plots) was proposed to estimate DV(T) for the quantification of reversible tracer kinetics that may not be at relative equilibrium states during PET study period. The RE-GP plots and the Logan plot were evaluated by 19 [(11)C]WIN35,428 and 10 [(11)C]MDL100,907 normal human dynamic PET studies with brain tissue tracer kinetics measured at both region of interest (ROI) and pixel levels. A 2-tissue compartment model (2TCM) was used to fit ROI time activity curves (TACs). By applying multi-graphical plots to the 2TCM fitted ROI TACs which were considered as the noise-free tracer kinetics, the estimates of DV(T) from the RE-GP plots, the Logan plot, and the 2TCM fitting were equal to each other. For the measured ROI TACs, there was no significant difference between the estimates of the DV(T) from the RE-GP plots and those from 2TCM fitting (p=0.77), but the estimates of the DV(T) from the Logan plot were significantly (p<0.001) lower, 2.3% on average, than those from 2TCM fitting. There was a highly linear correlation between the ROI DV(T) from the parametric images (Y) and those from the ROI kinetics (X) by using the RE-GP plots (Y=1.01X+0.23, R(2)=0.99). For the Logan plot, the ROI estimates from the parametric images were 13% to 83% lower than those from ROI kinetics. The computational time for generating parametric images was reduced by 69% on average by the RE-GP plots in contrast to the Logan plot. In conclusion, the bi-graphical analysis method using the RE-GP plots was a reliable, robust and computationally efficient kinetic modeling approach to improve the quantification of dynamic PET.
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Edison P, Brooks DJ, Turkheimer FE, Archer HA, Hinz R. Strategies for the generation of parametric images of [11C]PIB with plasma input functions considering discriminations and reproducibility. Neuroimage 2009; 48:329-38. [PMID: 19591948 DOI: 10.1016/j.neuroimage.2009.06.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 05/31/2009] [Accepted: 06/29/2009] [Indexed: 11/26/2022] Open
Abstract
Pittsburgh compound B or [11C]PIB is an amyloid imaging agent which shows a clear differentiation between subjects with Alzheimer's disease (AD) and controls. However the observed signal difference in other forms of dementia such as dementia with Lewy bodies (DLB) is smaller, and mild cognitively impaired (MCI) subjects and some healthy elderly normals may show intermediate levels of [11C]PIB binding. The cerebellum, a commonly used reference region for non-specific tracer uptake in [11C]PIB studies in AD may not be valid in Prion disorders or monogenic forms of AD. The aim of this work was to: 1-compare methods for generating parametric maps of [11C]PIB retention in tissue using a plasma input function in respect of their ability to discriminate between AD subjects and controls and 2-estimate the test-retest reproducibility in AD subjects. 12 AD subjects (5 of which underwent a repeat scan within 6 weeks) and 10 control subjects had 90 minute [11C]PIB dynamic PET scans, and arterial plasma input functions were measured. Parametric maps were generated with graphical analysis of reversible binding (Logan plot), irreversible binding (Patlak plot), and spectral analysis. Between group differentiation was calculated using Student's t-test and comparisons between different methods were made using p values. Reproducibility was assessed by intraclass correlation coefficients (ICC). We found that the 75 min value of the impulse response function showed the best group differentiation and had a higher ICC than volume of distribution maps generated from Logan and spectral analysis. Patlak analysis of [11C]PIB binding was the least reproducible.
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Affiliation(s)
- Paul Edison
- Medical Research Council Clinical Sciences Centre and Division of Neuroscience, Hammersmith Hospital, Imperial College London, UK.
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