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Song M, Beyer L, Kaiser L, Barthel H, van Eimeren T, Marek K, Nitschmann A, Scheifele M, Palleis C, Respondek G, Kern M, Biechele G, Hammes J, Bischof G, Barbe M, Onur Ö, Jessen F, Saur D, Schroeter ML, Rumpf JJ, Rullmann M, Schildan A, Patt M, Neumaier B, Barret O, Madonia J, Russell DS, Stephens AW, Mueller A, Roeber S, Herms J, Bötzel K, Danek A, Levin J, Classen J, Höglinger GU, Bartenstein P, Villemagne V, Drzezga A, Seibyl J, Sabri O, Boening G, Ziegler S, Brendel M. Binding characteristics of [ 18F]PI-2620 distinguish the clinically predicted tau isoform in different tauopathies by PET. J Cereb Blood Flow Metab 2021; 41:2957-2972. [PMID: 34044665 PMCID: PMC8545042 DOI: 10.1177/0271678x211018904] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The novel tau-PET tracer [18F]PI-2620 detects the 3/4-repeat-(R)-tauopathy Alzheimer's disease (AD) and the 4R-tauopathies corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP). We determined whether [18F]PI-2620 binding characteristics deriving from non-invasive reference tissue modelling differentiate 3/4R- and 4R-tauopathies. Ten patients with a 3/4R tauopathy (AD continuum) and 29 patients with a 4R tauopathy (CBS, PSP) were evaluated. [18F]PI-2620 PET scans were acquired 0-60 min p.i. and the distribution volume ratio (DVR) was calculated. [18F]PI-2620-positive clusters (DVR ≥ 2.5 SD vs. 11 healthy controls) were evaluated by non-invasive kinetic modelling. R1 (delivery), k2 & k2a (efflux), DVR, 30-60 min standardized-uptake-value-ratios (SUVR30-60) and the linear slope of post-perfusion phase SUVR (9-60 min p.i.) were compared between 3/4R- and 4R-tauopathies. Cortical clusters of 4R-tau cases indicated higher delivery (R1SRTM: 0.92 ± 0.21 vs. 0.83 ± 0.10, p = 0.0007), higher efflux (k2SRTM: 0.17/min ±0.21/min vs. 0.06/min ± 0.07/min, p < 0.0001), lower DVR (1.1 ± 0.1 vs. 1.4 ± 0.2, p < 0.0001), lower SUVR30-60 (1.3 ± 0.2 vs. 1.8 ± 0.3, p < 0.0001) and flatter slopes of the post-perfusion phase (slope9-60: 0.006/min ± 0.007/min vs. 0.016/min ± 0.008/min, p < 0.0001) when compared to 3/4R-tau cases. [18F]PI-2620 binding characteristics in cortical regions differentiate 3/4R- and 4R-tauopathies. Higher tracer clearance indicates less stable binding in 4R tauopathies when compared to 3/4R-tauopathies.
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Affiliation(s)
- Mengmeng Song
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Lena Kaiser
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Thilo van Eimeren
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany.,Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.,Department of Neurology, University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Ken Marek
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Alexander Nitschmann
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gesine Respondek
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Maike Kern
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jochen Hammes
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Gèrard Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Michael Barbe
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Özgür Onur
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Psychiatry, University Hospital Cologne, Cologne, Germany.,Center for Memory Disorders, University Hospital Cologne, Cologne, Germany
| | - Dorothee Saur
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Max- Planck-Institute of Human Cognitive and Brain Sciences, Leipzig, Germany.,FTLD Consortium Germany, Ulm, Germany
| | | | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Bernd Neumaier
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany.,Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Olivier Barret
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA.,Laboratoire des Maladies Neurodégénératives, Université Paris-Saclay, CEA, CNRS, MIRCen, Fontenay-aux-Roses, France
| | - Jennifer Madonia
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - David S Russell
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | | | | | - Sigrun Roeber
- Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jochen Herms
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Kai Bötzel
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Adrian Danek
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Johannes Levin
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Günter U Höglinger
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, Technical University Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Victor Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - John Seibyl
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Guido Boening
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sibylle Ziegler
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Hammes J, Bischof GN, Bohn KP, Onur Ö, Schneider A, Fliessbach K, Hönig MC, Jessen F, Neumaier B, Drzezga A, van Eimeren T. One-Stop Shop: 18F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases. J Nucl Med 2020; 62:240-246. [PMID: 32620704 DOI: 10.2967/jnumed.120.244061] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/30/2020] [Indexed: 02/06/2023] Open
Abstract
Tau protein aggregations are a hallmark of amyloid-associated Alzheimer disease and some forms of non-amyloid-associated frontotemporal lobar degeneration. In recent years, several tracers for in vivo tau imaging have been under evaluation. This study investigated the ability of 18F-flortaucipir PET not only to assess tau positivity but also to differentiate between amyloid-positive and -negative forms of neurodegeneration on the basis of different 18F-flortaucipir PET signatures. Methods: The 18F-flortaucipir PET data of 35 patients with amyloid-positive neurodegeneration, 19 patients with amyloid-negative neurodegeneration, and 17 healthy controls were included in a data-driven scaled subprofile model (SSM)/principal-component analysis (PCA) identifying spatial covariance patterns. SSM/PCA pattern expression strengths were tested for their ability to predict amyloid status in a receiver-operating-characteristic analysis and validated with a leave-one-out approach. Results: Pattern expression strengths predicted amyloid status with a sensitivity of 0.94 and a specificity of 0.83. A support vector machine classification based on pattern expression strengths in 2 different SSM/PCA components yielded a prediction accuracy of 98%. Anatomically, prediction performance was driven by parietooccipital gray matter in amyloid-positive patients versus predominant white matter binding in amyloid-negative patients. Conclusion: SSM/PCA-derived binding patterns of 18F-flortaucipir differentiate between amyloid-positive and -negative neurodegenerative diseases with high accuracy. 18F-flortaucipir PET alone may convey additional information equivalent to that from amyloid PET. Together with a perfusion-weighted early-phase acquisition (18F-FDG PET-equivalent), a single scan potentially contains comprehensive information on amyloid (A), tau (T), and neurodegeneration (N) status as required by recent biomarker classification algorithms (A/T/N).
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Affiliation(s)
- Jochen Hammes
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany .,Radiologische Allianz, Hamburg, Germany
| | - Gérard N Bischof
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
| | - Karl P Bohn
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Department of Nuclear Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Özgür Onur
- Department of Neurology, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Merle C Hönig
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Molecular Organization of the Brain (INM-2), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Department of Psychiatry, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany; and
| | - Bernd Neumaier
- Nuclear Chemistry (INM-5), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany, and Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
| | - Alexander Drzezga
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Molecular Organization of the Brain (INM-2), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Department of Neurology, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany
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Borggrefe J, Glück B, Maus V, Onur Ö, Abdullayev N, Barnikol U, Kabbasch C, Fink GR, Mpotsaris A. Clinical Outcome After Mechanical Thrombectomy in Patients with Diabetes with Major Ischemic Stroke of the Anterior Circulation. World Neurosurg 2018; 120:e212-e220. [PMID: 30121406 DOI: 10.1016/j.wneu.2018.08.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 04/30/2018] [Revised: 08/05/2018] [Accepted: 08/06/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Among patients with acute ischemic stroke treated with mechanical thrombectomy (MT), patients with diabetes (DP) show a poorer outcome compared with patients without diabetes (NDP). This study aims to provide a comprehensive analysis of factors associated with unfavorable outcome in DP receiving MT for stroke of the anterior circulation. METHODS This study included 317 of 498 consecutive patients who received interventional treatment for acute ischemic stroke in the terminal internal carotid artery and/or middle cerebral artery, including 46 DP. The study data included pre- and posttreatment stroke computed tomography, including perfusion data, collateral status, treatment data including treatment times, pre-existing cardiovascular risk factors, cerebrovascular events, comorbidities, laboratory parameters, and medication. Neurologic status was assessed at baseline (National Institute of Health Stroke Scale [NIHSS]/modified Rankin Scale [mRS]) and after 90 days (mRS 90). RESULTS Compared with NDP, DP showed a significantly poorer outcome (mRS90 >2) (P < 0.05). Collateralization and infarct core size did not differ between groups, whereas the penumbra was significantly smaller in DP than in NDP (P < 0.05). The poorer mRS90 outcome (mRS90 > 2) in DP was associated with poor collaterals (P = 0.01) and hyperglycemia on admission (P < 0.05). Shorter time to reperfusion was associated with favorable mRS90 in the NDP (P < 0.001) but not the DP (P = 0.49) group. In univariate logistic regression, the following parameters were significantly associated with mRS90: diabetes, hyperglycemia at admission, time to reperfusion, and the NIHSS score (P < 0.05 each). In multivariate analyses and partition regression models of all variables, DP with admission hyperglycemia (≥132 mg/dL) and older age (≥66 years) showed a particularly poor outcome. CONCLUSIONS The main factors for an unfavorable outcome of DP after MT are admission hyperglycemia, age, and NIHSS score.
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Affiliation(s)
- Jan Borggrefe
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Cologne, Germany.
| | - Berit Glück
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Cologne, Germany
| | - Volker Maus
- Department of Neuroradiology, University Hospital of Göttingen, Göttingen, Germany
| | - Özgür Onur
- Department of Neurology, University Hospital of Cologne, Cologne, Germany
| | - Nuran Abdullayev
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Cologne, Germany
| | - Utako Barnikol
- Medical Ethics, University Hospital of Cologne, Cologne, Germany
| | - Christoph Kabbasch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Cologne, Germany
| | - Gereon Rudolf Fink
- Department of Neurology, University Hospital of Cologne, Cologne, Germany
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