Department of Radiology, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan Institute of Advanced Clinical Medicine, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
Department of Radiology, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan Neurocognitive Disorders Center, Kinki University Hospital, Osakasayama, Osaka, Japan; and.
J Nucl Med. 2015 Dec;56(12):1910-5. doi: 10.2967/jnumed.115.156414. Epub 2015 Sep 10.
The goal of this study was to clarify whether binding potential (BP) images using (11)C-Pittsburgh compound B ((11)C-PiB) and dynamic PET can reliably detect cortical amyloid deposits for patients whose (11)C-PiB PET static images are ambiguous and whether visual ratings are affected by white matter retention.
Static and BP images were constructed for 85 consecutive patients with cognitive impairment after (11)C-PiB dynamic PET. Cortical uptake was visually assessed as positive, negative, or equivocal for both types of images. Quantitatively, the standardized uptake value ratio (SUVR) from the static image, the nondisplaceable BP from the dynamic image for mean gray matter uptake, and the ratio of gray matter uptake to white matter retention were compared among (11)C-PiB-positive, (11)C-PiB-equivocal, and (11)C-PiB-negative groups.
Forty-three scans were visually assessed as (11)C-PiB-positive in both the static and the BP images. Ten scans were (11)C-PiB-equivocal in the static images. In 8 of them, the BP images were (11)C-PiB-positive, whereas the other 2 were (11)C-PiB-equivocal. Thirty-two scans were assessed as (11)C-PiB-negative in the static images. In the BP images, 4 were (11)C-PiB-positive and 2 were (11)C-PiB-equivocal. The mean gray matter uptake of (11)C-PiB in SUVR and nondisplaceable BP, respectively, showed statistically significant differences among the (11)C-PiB-positive, (11)C-PiB-equivocal, and (11)C-PiB-negative groups. The ratio of gray matter uptake to white matter retention was lower in the BP images than static images from the (11)C-PiB-negative and (11)C-PiB-equivocal groups, whereas it was higher in the (11)C-PiB-positive group.
(11)C-PiB PET BP images can clarify visual interpretation of clinical static (11)C-PiB-equivocal images by reducing the interference of nonspecific white matter retention. We conclude that (11)C-PiB-equivocal PET findings on static images reflect cortical amyloid deposits, which can be verified using BP images. Furthermore, quantitative assessments, such as SUVR and nondisplaceable BP, are of no use for correctly rating equivocal visual findings.
本研究旨在阐明对于（11）C-Pittsburgh 化合物 B（（11）C-PiB）正电子发射断层扫描（PET）动态图像结果不确定的患者，（11）C-PiB 结合位（BP）图像能否可靠地检测皮质淀粉样蛋白沉积，以及视觉评分是否受白质保留的影响。
对 85 例认知障碍患者的（11）C-PiB PET 动态图像构建静态和 BP 图像。两种图像均对皮质摄取进行阳性、阴性或不确定的视觉评估。定量比较静态图像标准化摄取值比（SUVR）、平均灰质摄取的动态图像无置换 BP、灰质摄取与白质保留的比值，在（11）C-PiB 阳性、（11）C-PiB 不确定和（11）C-PiB 阴性组间进行比较。
43 例患者的静态和 BP 图像均为（11）C-PiB 阳性。10 例患者的静态图像为（11）C-PiB 不确定，其中 8 例 BP 图像为（11）C-PiB 阳性，2 例为（11）C-PiB 不确定。32 例患者的静态图像为（11）C-PiB 阴性。BP 图像中，4 例为（11）C-PiB 阳性，2 例为（11）C-PiB 不确定。（11）C-PiB 在 SUVR 和无置换 BP 中的平均灰质摄取在（11）C-PiB 阳性、（11）C-PiB 不确定和（11）C-PiB 阴性组间存在统计学差异。与（11）C-PiB 阴性和（11）C-PiB 不确定组相比，BP 图像的灰质摄取与白质保留比值更低，（11）C-PiB 阳性组更高。
（11）C-PiB PET BP 图像可通过减少非特异性白质保留的干扰，阐明临床静态（11）C-PiB 不确定图像的视觉解释。我们的结论是，静态图像上的（11）C-PiB 不确定 PET 结果反映皮质淀粉样蛋白沉积，可通过 BP 图像进行验证。此外，SUVR 和无置换 BP 等定量评估对于正确评价不确定的视觉结果没有帮助。
