Multimodal Neuroimaging Group, Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.
INM-3, Research Center Jülich, Jülich, Germany.
Eur J Nucl Med Mol Imaging. 2017 Dec;44(13):2249-2256. doi: 10.1007/s00259-017-3840-z. Epub 2017 Oct 12.
Cerebral glucose metabolism measured with [18F]-FDG PET is a well established marker of neuronal dysfunction in neurodegeneration. The tau-protein tracer [18F]-AV-1451 PET is currently under evaluation and shows promising results. Here, we assess the feasibility of early perfusion imaging with AV-1451 as a substite for FDG PET in assessing neuronal injury.
Twenty patients with suspected neurodegeneration underwent FDG and early phase AV-1451 PET imaging. Ten one-minute timeframes were acquired after application of 200 MBq AV-1451. FDG images were acquired on a different date according to clinical protocol. Early AV-1451 timeframes were coregistered to individual FDG-scans and spatially normalized. Voxel-wise intermodal correlations were calculated on within-subject level for every possible time window. The window with highest pooled correlation was considered optimal. Z-transformed deviation maps (ZMs) were created from both FDG and early AV-1451 images, comparing against FDG images of healthy controls.
Regional patterns and extent of perfusion deficits were highly comparable to metabolic deficits. Best results were observed in a time window from 60 to 360 s (r = 0.86). Correlation strength ranged from r = 0.96 (subcortical gray matter) to 0.83 (frontal lobe) in regional analysis. ZMs of early AV-1451 and FDG images were highly similar.
Perfusion imaging with AV-1451 is a valid biomarker for assessment of neuronal dysfunction in neurodegenerative diseases. Radiation exposure and complexity of the diagnostic workup could be reduced significantly by routine acquisition of early AV-1451 images, sparing additional FDG PET.
用 [18F]-FDG PET 测量脑葡萄糖代谢是神经退行性变中神经元功能障碍的一种成熟标志物。tau 蛋白示踪剂 [18F]-AV-1451 PET 目前正在评估中，结果有很大希望。在这里，我们评估了用 AV-1451 进行早期灌注成像作为评估神经元损伤的 FDG PET 替代物的可行性。
20 名疑似神经退行性变的患者接受了 FDG 和早期 AV-1451 PET 成像。在注射 200MBq AV-1451 后采集 10 个 1 分钟的时间帧。FDG 图像根据临床方案在不同日期采集。早期 AV-1451 时间帧与个体 FDG 扫描进行配准和空间归一化。在个体水平上计算每一个可能的时间窗口的模态间互相关。具有最高相关性的窗口被认为是最佳的。从 FDG 和早期 AV-1451 图像中创建了 Z 变换偏差图（ZMs），并与健康对照组的 FDG 图像进行比较。
灌注缺陷的区域模式和程度与代谢缺陷高度相似。最佳结果出现在 60 到 360 秒的时间窗口（r=0.86）。在区域分析中，相关性强度从 r=0.96（皮质下灰质）到 0.83（额叶）不等。早期 AV-1451 和 FDG 图像的 ZMs 非常相似。
用 AV-1451 进行灌注成像，是评估神经退行性疾病神经元功能障碍的有效生物标志物。通过常规采集早期 AV-1451 图像，可以显著减少放射性暴露和诊断工作流程的复杂性，节省额外的 FDG PET。
