Daerr Sonja, Brendel Matthias, Zach Christian, Mille Erik, Schilling Dorothee, Zacherl Mathias Johannes, Bürger Katharina, Danek Adrian, Pogarell Oliver, Schildan Andreas, Patt Marianne, Barthel Henryk, Sabri Osama, Bartenstein Peter, Rominger Axel
Dept. of Nuclear Medicine, Ludwig-Maximilians-Universität München, München, Germany.
ISD, Ludwig-Maximilians-Universität München, München, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
Neuroimage Clin. 2016 Oct 8;14:77-86. doi: 10.1016/j.nicl.2016.10.005. eCollection 2017.
OBJECTIVES: In recent years several [F]-labelled amyloid PET tracers have been developed and have obtained clinical approval. There is accumulating evidence that early (post injection) acquisitions with these tracers are equally informative as conventional blood flow and metabolism studies for diagnosis of Alzheimer's disease, but there have been few side-by-side studies. Therefore, we investigated the performance of early acquisitions of [F]-florbetaben (FBB) PET compared to [F]-fluorodeoxyglucose (FDG) PET in a clinical setting. METHODS: All subjects were recruited with clinical suspicion of dementia due to neurodegenerative disease. FDG PET was undertaken by conventional methods, and amyloid PET was performed with FBB, with early recordings for the initial 10 min (early-phase FBB), and late recordings at 90-110 min p.i. (late-phase FBB). Regional SUVR with cerebellar and global mean normalization were calculated for early-phase FBB and FDG PET. Pearson correlation coefficients between FDG and early-phase FBB were calculated for predefined cortical brain regions. Furthermore, a visual interpretation of disease pattern using 3-dimensional stereotactic surface projections (3D-SSP) was performed, with assessment of intra-reader agreement. RESULTS: Among a total of 33 patients (mean age 67.5 ± 11.0 years) included in the study, 18 were visually rated amyloid-positive, and 15 amyloid-negative based on late-phase FBB scans. Correlation coefficients for early-phase FBB vs. FDG scans displayed excellent agreement in all target brain regions for global mean normalization. Cerebellar normalization gave strong, but significantly lower correlations. 3D representations of early-phase FBB visually resembled the corresponding FDG PET images, irrespective of the amyloid-status of the late FBB scans. CONCLUSIONS: Early-phase FBB acquisitions correlate on a relative quantitative and visual level with FDG PET scans, irrespective of the amyloid plaque density assessed in late FBB imaging. Thus, early-phase FBB uptake depicts a metabolism-like image, suggesting it as a valid surrogate marker for synaptic dysfunction, which could ultimately circumvent the need for additional FDG PET investigation in diagnosis of dementia.
目的:近年来,几种[F]标记的淀粉样蛋白PET示踪剂已被开发并获得临床批准。越来越多的证据表明,使用这些示踪剂进行早期(注射后)采集对于阿尔茨海默病的诊断与传统的血流和代谢研究同样具有信息价值,但很少有并行研究。因此,我们在临床环境中研究了[F] - 氟代贝他苯(FBB)PET早期采集与[F] - 氟脱氧葡萄糖(FDG)PET相比的性能。 方法:所有受试者均因神经退行性疾病临床怀疑患有痴呆症而被招募。FDG PET采用传统方法进行,淀粉样蛋白PET使用FBB进行,最初10分钟进行早期记录(早期FBB),注射后90 - 110分钟进行晚期记录(晚期FBB)。计算早期FBB和FDG PET的小脑和全局平均归一化区域标准化摄取值(SUVR)。计算预定义皮质脑区FDG与早期FBB之间的Pearson相关系数。此外,使用三维立体定向表面投影(3D - SSP)对疾病模式进行视觉解释,并评估阅片者内部一致性。 结果:在该研究纳入的总共33例患者(平均年龄67.5±11.0岁)中,根据晚期FBB扫描,18例在视觉上被评为淀粉样蛋白阳性,15例为淀粉样蛋白阴性。早期FBB与FDG扫描的相关系数在所有目标脑区的全局平均归一化方面显示出极好的一致性。小脑归一化给出了很强但明显较低的相关性。早期FBB的3D图像在视觉上类似于相应的FDG PET图像,与晚期FBB扫描的淀粉样蛋白状态无关。 结论:早期FBB采集在相对定量和视觉水平上与FDG PET扫描相关,与晚期FBB成像中评估的淀粉样斑块密度无关。因此,早期FBB摄取描绘了一种类似代谢的图像,表明它是突触功能障碍的有效替代标志物,这最终可能避免在痴呆症诊断中进行额外的FDG PET检查。
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