Piramal Imaging GmbH, Berlin, Germany.
Piramal Imaging GmbH, Berlin, Germany
J Nucl Med. 2016 Nov;57(11):1740-1745. doi: 10.2967/jnumed.115.171652. Epub 2016 Jun 30.
SUV ratios (SUVRs) are used for relative quantification of F-florbetaben scans. The cerebellar cortex can be used as a reference region for quantification. However, cerebellar amyloid-β (Aβ) plaques may be present in Alzheimer disease (AD). The aim of this study was to assess the influence of Aβ pathology, including neuritic plaques, diffuse plaques, and vascular deposits, in F-florbetaben SUVR when cerebellum is used as the reference.
Using immunohistochemistry to demonstrate Aβ plaques and vascular deposits, and using the Bielschowsky method to demonstrate neuritic plaques, we performed a neuropathologic assessment of the frontal, occipital, anterior cingulate, and posterior cingulate cerebral cortices and the cerebellar cortex of 87 end-of-life patients (64 with AD, 14 with other types of dementia, and 9 nondemented aged volunteers; mean age ± SD, 80.4 ± 10.2 y) who had undergone F-florbetaben PET before death. The lesions were rated as absent (none or sparse) or present (moderate or frequent). Mean cortical SUVRs were compared among cases with different cerebellar Aβ loads.
None of the 83 evaluable cerebellar samples showed frequent diffuse Aβ or neuritic plaques; 8 samples showed frequent vascular Aβ deposits. Diffuse Aβ plaques were rated as absent in 78 samples (94%) and present in 5 samples (6%). Vascular Aβ was rated as absent in 62 samples (74.7%) and present in 21 samples (25.3%). No significant differences in cerebellar SUVs were found among cases with different amounts or types of Aβ deposits in the cerebral cortex. Both diffuse and neuritic plaques were found in the cerebral cortex of 26-44 cases. No significant SUVR differences were found between these brains with different cerebellar Aβ loads.
The effect of cerebellar plaques on cortical F-florbetaben SUVRs appears to be negligible even in advanced stages of AD with a higher cerebellar Aβ load.
评估小脑 Aβ 斑块（包括神经纤维缠结、弥散斑块和血管沉积）对采用小脑作为参照进行 F-氟比洛芬 SUVR 定量的影响。
采用免疫组织化学方法显示 Aβ 斑块和血管沉积，采用 Bielschowsky 方法显示神经纤维缠结，对 87 例终末期患者（64 例 AD，14 例其他类型痴呆，9 例非痴呆老年志愿者；平均年龄±标准差，80.4±10.2 岁）的额、顶、前扣带回和后扣带回皮质以及小脑皮质进行了神经病理学评估，这些患者在死亡前均进行了 F-氟比洛芬 PET 检查。病变被评为无（无或稀疏）或有（中度或频繁）。比较不同小脑 Aβ 负荷病例的皮质 SUVR。
83 例可评估的小脑样本中均无弥漫性 Aβ 或神经纤维缠结斑块；8 例样本有弥漫性 Aβ 沉积；78 例（94%）样本无弥散性 Aβ 斑块，5 例（6%）有；62 例（74.7%）无血管 Aβ，21 例（25.3%）有。皮质内 Aβ 沉积量或类型不同的病例，小脑 SUV 无显著差异。26-44 例病例的皮质内有弥漫性和神经纤维缠结斑块。这些小脑 Aβ 负荷不同的大脑之间，SUVR 无显著差异。
即使在 AD 晚期，小脑斑块对皮质 F-氟比洛芬 SUVR 的影响似乎可以忽略不计，且小脑 Aβ 负荷较高。
