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欧洲和北美队列中的淀粉样蛋白正电子发射断层扫描;以及探讨年龄作为淀粉样蛋白成像临床应用的限制因素。

Amyloid PET in European and North American cohorts; and exploring age as a limit to clinical use of amyloid imaging.

作者信息

Chiotis Konstantinos, Carter Stephen F, Farid Karim, Savitcheva Irina, Nordberg Agneta

机构信息

Department of NVS, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Karolinska Institutet, Stockholm, Sweden.

出版信息

Eur J Nucl Med Mol Imaging. 2015 Sep;42(10):1492-506. doi: 10.1007/s00259-015-3115-5. Epub 2015 Jul 2.

Abstract

PURPOSE

Several radiotracers that bind to fibrillar amyloid-beta in the brain have been developed and used in various patient cohorts. This study aimed to investigate the comparability of two amyloid positron emission tomography (PET) tracers as well as examine how age affects the discriminative properties of amyloid PET imaging.

METHODS

Fifty-one healthy controls (HCs), 72 patients with mild cognitive impairment (MCI) and 90 patients with Alzheimer's disease (AD) from a European cohort were scanned with [11C]Pittsburgh compound-B (PIB) and compared with an age-, sex- and disease severity-matched population of 51 HC, 72 MCI and 84 AD patients from a North American cohort who were scanned with [18F]Florbetapir. An additional North American population of 246 HC, 342 MCI and 138 AD patients with a Florbetapir scan was split by age (55-75 vs 76-93 y) into groups matched for gender and disease severity. PET template-based analyses were used to quantify regional tracer uptake.

RESULTS

The mean regional uptake patterns were similar and strong correlations were found between the two tracers across the regions of interest in HC (ρ = 0.671, p = 0.02), amyloid-positive MCI (ρ = 0.902, p < 0.001) and AD patients (ρ = 0.853, p < 0.001). The application of the Florbetapir cut-off point resulted in a higher proportion of amyloid-positive HC and a lower proportion of amyloid-positive AD patients in the older group (28 and 30 %, respectively) than in the younger group (19 and 20 %, respectively).

CONCLUSIONS

These results illustrate the comparability of Florbetapir and PIB in unrelated but matched patient populations. The role of amyloid PET imaging becomes increasingly important with increasing age in the diagnostic assessment of clinically impaired patients.

摘要

目的

已研发出多种可与大脑中纤维状β淀粉样蛋白结合的放射性示踪剂,并应用于不同患者群体。本研究旨在调查两种淀粉样蛋白正电子发射断层扫描(PET)示踪剂的可比性,并研究年龄如何影响淀粉样蛋白PET成像的鉴别特性。

方法

对来自欧洲队列的51名健康对照者(HC)、72名轻度认知障碍(MCI)患者和90名阿尔茨海默病(AD)患者进行[11C]匹兹堡化合物B(PIB)扫描,并与来自北美队列的51名HC、72名MCI和84名AD患者组成的年龄、性别和疾病严重程度匹配人群进行比较,后者接受了[18F]氟代贝他吡扫描。另外,对246名HC、342名MCI和138名接受氟代贝他吡扫描的AD患者组成的北美人群,按年龄(55 - 75岁与76 - 93岁)分为性别和疾病严重程度匹配的组。基于PET模板的分析用于量化区域示踪剂摄取。

结果

平均区域摄取模式相似,在HC(ρ = 0.671,p = 0.02)、淀粉样蛋白阳性的MCI(ρ = 0.902,p < 0.001)和AD患者(ρ = 0.853,p < 0.001)的感兴趣区域中,两种示踪剂之间发现了强相关性。应用氟代贝他吡的截断点时,老年组中淀粉样蛋白阳性的HC比例较高(分别为28%和30%),淀粉样蛋白阳性的AD患者比例较低,而年轻组中的比例分别为19%和20%。

结论

这些结果说明了氟代贝他吡和PIB在不相关但匹配的患者群体中的可比性。在临床受损患者的诊断评估中,随着年龄增长,淀粉样蛋白PET成像的作用变得越来越重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d0e/4521094/0ebbe5359147/259_2015_3115_Fig1_HTML.jpg

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