Brumberg Joachim, Tran-Gia Johannes, Lapa Constantin, Isaias Ioannis U, Samnick Samuel
Department of Nuclear Medicine, University Hospital and Julius-Maximilians-University, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
Department of Neurology, University Hospital and Julius-Maximilians-University, Josef-Schneider-Straße 11, 97080, Würzburg, Germany.
Ann Nucl Med. 2019 Feb;33(2):69-77. doi: 10.1007/s12149-018-1305-5. Epub 2018 Oct 6.
In subjects with idiopathic Parkinson's disease (PD) the functional state of the locus coeruleus and the subtle derangements in the finely tuned dopamine-noradrenaline interplay are largely unknown. The PET ligand (S,S)-[C]-O-methylreboxetine (C-11 MRB) has been described to reliably bind noradrenaline transporters but long scanning protocols might hamper its use, especially in patients with PD. We aimed to assess the feasibility of reducing C-11 MRB scans to 30 min.
Ten patients with idiopathic PD underwent dynamic C-11 MRB PET (120 min duration) and brain magnetic resonance imaging. Model-based (i.e., simplified and multilinear reference tissue model 2) non-displaceable binding potentials (BP) of selected brain regions were analyzed for a 90 min scan protocol and compared with BP derived from static 30-min data with different starting times (30, 40, 50 and 60 min) after C-11 MRB injection. Intraclass correlation coefficient and linear regression analysis were used to explore the association between BP of different scan durations. Spearman's ρ served to describe the correlation of BP with demographic and clinical parameters.
With respect to kinetic models, BP and BP showed the best correlation in several brain areas (R range 0.95-98; p < 0.001). The thalamus showed the highest BP on average. No correlation between BP, clinical and demographic characteristics was observed.
An acquisition time of 30 min, starting 50 or 60 min after C-11 MRB injection, allows a reliable estimation of noradrenaline transporter binding values in Parkinsonian people. A short acquisition time can significantly reduce the discomfort of Parkinsonian patients and facilitate PET studies, especially in the medication-off-state.
在特发性帕金森病（PD）患者中，蓝斑的功能状态以及多巴胺 - 去甲肾上腺素精细调节相互作用中的细微紊乱在很大程度上尚不清楚。正电子发射断层扫描（PET）配体（S,S）-[碳]-O-甲基瑞波西汀（C-11 MRB）已被描述为能可靠地结合去甲肾上腺素转运体，但较长的扫描方案可能会妨碍其应用，尤其是在PD患者中。我们旨在评估将C-11 MRB扫描时间缩短至30分钟的可行性。
10例特发性PD患者接受了动态C-11 MRB PET（持续时间120分钟）和脑磁共振成像。对选定脑区基于模型（即简化和多线性参考组织模型2）的不可置换结合电位（BP）进行了90分钟扫描方案的分析，并与C-11 MRB注射后不同起始时间（30、40、50和60分钟）的静态30分钟数据得出的BP进行比较。使用组内相关系数和线性回归分析来探索不同扫描持续时间的BP之间的关联。Spearman's ρ用于描述BP与人口统计学和临床参数的相关性。
就动力学模型而言，BP在几个脑区显示出最佳相关性（R范围为0.95 - 0.98；p < 0.001）。丘脑平均BP最高。未观察到BP与临床和人口统计学特征之间的相关性。
在C-11 MRB注射后50或60分钟开始的30分钟采集时间，能够可靠地估计帕金森病患者的去甲肾上腺素转运体结合值。短采集时间可显著减轻帕金森病患者的不适，并有助于PET研究，尤其是在未用药状态下。
