Neurology, PET Center, Shonan-Atsugi Hospital, 118-1 Murumizu, Atsugi, 243-8551, Japan,
Eur J Nucl Med Mol Imaging. 2014 Feb;41(2):290-300. doi: 10.1007/s00259-013-2564-y. Epub 2013 Oct 2.
The aim was to identify the amyloid beta (Aβ) deposition by positron emission tomography (PET) imaging with the (18)F-labeled Pittsburgh compound B (PIB) derivative [(18)F]flutemetamol (FMM) across a spectrum of Alzheimer's disease (AD) and to compare Aβ deposition between [(18)F]FMM and [(11)C]PIB PET imaging.
The study included 36 patients with AD, 68 subjects with mild cognitive impairment (MCI), 41 older healthy controls (HC) (aged ≥56), 11 young HC (aged ≤45), and 10 transitional HC (aged 46-55). All 166 subjects underwent 30-min static [(18)F]FMM PET 85 min after injection, 60-min dynamic [(11)C]PIB PET, and cognitive testing. [(18)F]FMM scans were assessed visually, and standardized uptake value ratios (SUVR) were defined quantitatively in regions of interest identified on coregistered MRI (cerebellar cortex as a reference region). The PIB distribution volume ratios (DVR) were determined in the same regions.
Of 36 AD patients, 35 had positive scans, while 36 of 41 older HC subjects had negative scans. [(18)F]FMM scans had a sensitivity of 97.2% and specificity of 85.3% in distinguishing AD patients from older HC subjects, and a specificity of 100% for young and transitional HC subjects. The [(11)C]PIB scan had the same results. Interreader agreement was excellent (kappa score = 0.81). The cortical FMM SUVR in AD patients was significantly greater than in older HC subjects (1.76 ± 0.23 vs 1.30 ± 0.26, p < 0.01). Of the MCI patients, 68 had a bimodal distribution of SUVR, and 29 of them (42.6%) had positive scans. Cortical FMM SUVR values were strongly correlated with PIB DVR (r = 0.94, n = 145, p < 0.001).
[(18)F]FMM PET imaging detects Aβ deposition in patients along the continuum from normal cognitive status to dementia of AD and discriminates AD patients from HC subjects, similar to [(11)C]PIB PET.
本研究旨在通过正电子发射断层扫描（PET）成像，利用（18）F 标记的匹兹堡化合物 B（PIB）衍生物（18）F-氟甲基美金刚（FMM）识别阿尔茨海默病（AD）患者的淀粉样蛋白-β（Aβ）沉积，并比较（18）F-FMM 和（11）C-PIB PET 成像在 Aβ 沉积方面的差异。
本研究纳入 36 例 AD 患者、68 例轻度认知障碍（MCI）患者、41 例老年健康对照者（HC）（年龄≥56 岁）、11 例年轻 HC（年龄≤45 岁）和 10 例中年 HC（年龄 46-55 岁）。所有 166 例受试者在注射后 85 分钟进行 30 分钟静态（18）F-FMM PET 扫描、60 分钟动态（11）C-PIB PET 扫描和认知测试。（18）F-FMM 扫描通过视觉评估，在与 MRI 配准的感兴趣区（小脑皮质作为参考区）中定义标准化摄取值比（SUVR）进行定量评估。在相同区域确定 PIB 分布容积比（DVR）。
36 例 AD 患者中，35 例扫描结果阳性，41 例老年 HC 受试者中，36 例扫描结果阴性。（18）F-FMM 扫描在区分 AD 患者和老年 HC 受试者方面具有 97.2%的敏感性和 85.3%的特异性，在区分年轻和中年 HC 受试者方面具有 100%的特异性。（11）C-PIB 扫描也有相同的结果。两位阅片者的一致性非常好（kappa 评分=0.81）。AD 患者的皮质 FMM SUVR 明显高于老年 HC 受试者（1.76±0.23 比 1.30±0.26，p<0.01）。在 MCI 患者中，68 例患者 SUVR 呈双峰分布，其中 29 例（42.6%）扫描结果阳性。皮质 FMM SUVR 值与 PIB DVR 呈强相关（r=0.94，n=145，p<0.001）。
（18）F-FMM PET 成像可在从正常认知状态到 AD 痴呆的连续过程中检测到 Aβ 沉积，并能区分 AD 患者和 HC 受试者，与（11）C-PIB PET 成像相似。
