淀粉样β蛋白沉积定量中参考信号强度的参数估计：一项F-AV-45研究
Parametric estimation of reference signal intensity in the quantification of amyloid-beta deposition: an F-AV-45 study.
作者信息
Wang Min, Yan Zhuangzhi, Zhang Huiwei, Lu Jiaying, Li Ling, Yu Jintai, Wang Jian, Matsuda Hiroshi, Zuo Chuantao, Jiang Jiehui
机构信息
Shanghai Institute for Advanced Communication and Data Science, School of Communication and Information Engineering, Shanghai University, Shanghai, China.
Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China.
出版信息
Quant Imaging Med Surg. 2021 Jan;11(1):249-263. doi: 10.21037/qims-20-110.
BACKGROUND
Positron emission tomography (PET) with the radiotracer florbetapir (F-AV-45) allows the pathophysiology of Alzheimer's disease (AD) to be tracked in vivo. The semi-quantification of amyloid-beta (Aβ) has been extensively evaluated with the standardized uptake value ratio (SUVR) but is susceptible to disturbance from the candidate reference region and the partial volume effect (PVE). In the present study, we applied the parametric estimation of reference signal intensity (PERSI) method to F-AV-45 PET images for intensity normalization.
METHODS
We enrolled 479 people with F-AV-45 images from the Alzheimer's Disease Neuroimaging Initiative database: 261 healthy controls (HCs), 102 patients with mild cognitive impairment (MCI), and 116 AD patients. We used white matter post-processed by PERSI (PERSI-WM) as the reference region and compared our proposed method with the traditional method for semi-quantification. SUVRs were calculated for eight regions of interest: the frontal lobe, the parietal lobe, the temporal lobe, the occipital lobe, the anterior cingulate cortex, the posterior cingulate cortex, the precuneus, and the global cortex. The SUVRs derived from PERSI-WM and other reference regions were evaluated by effect size and receiver-operator characteristic curve analyses.
RESULTS
The SUVRs derived from PERSI-WM showed significantly higher trace retention in the frontal, parietal, temporal, and occipital lobes, as well as in the anterior cingulate, posterior cingulate, precuneus, and global cortex in the AD Aβ-positive (+) group (mean: +43.3%±5.4%, P<0.01) and MCI Aβ+ group (mean: +29.6%±5.3%, P<0.01). For the global cortex, PERSI-WM had the greatest Cohen's d effect size compared with the HC Aβ-negative (-) group (AD Aβ+ and MCI Aβ+: 3.02, AD Aβ+: 3.56, MCI Aβ+: 2.34), and the highest area under the curve (AUC) between the HC Aβ- and AD Aβ+ groups (AUC: 0.983, 95% confidence interval: 0.978-0.998).
CONCLUSIONS
PERSI-WM could mitigate the influence of PVE and improve the semi-quantification of F-AV-45 images; therefore, it could be used for large-scale clinical application in the nuclear medicine domain.
背景
使用放射性示踪剂氟比他派（F-AV-45）的正电子发射断层扫描（PET）能够在体内追踪阿尔茨海默病（AD）的病理生理过程。淀粉样β蛋白（Aβ）的半定量分析已通过标准化摄取值比率（SUVR）进行了广泛评估，但易受候选参考区域和部分容积效应（PVE）的干扰。在本研究中，我们将参考信号强度参数估计（PERSI）方法应用于F-AV-45 PET图像进行强度归一化。
方法
我们从阿尔茨海默病神经影像倡议数据库中纳入了479例有F-AV-45图像的受试者：261例健康对照（HC）、102例轻度认知障碍（MCI）患者和116例AD患者。我们将经PERSI后处理的白质（PERSI-WM）作为参考区域，并将我们提出的方法与传统半定量方法进行比较。计算了八个感兴趣区域的SUVR：额叶、顶叶、颞叶、枕叶、前扣带回皮质、后扣带回皮质、楔前叶和全脑皮质。通过效应量和受试者操作特征曲线分析评估了源自PERSI-WM和其他参考区域的SUVR。
结果
源自PERSI-WM的SUVR在AD Aβ阳性（+）组（平均值：+43.3%±5.4%，P<0.01）和MCI Aβ+组（平均值：+29.6%±5.3%，P<0.01）的额叶、顶叶、颞叶、枕叶以及前扣带回、后扣带回、楔前叶和全脑皮质中显示出显著更高的示踪剂滞留。对于全脑皮质，与HC Aβ阴性（-）组相比，PERSI-WM具有最大的科恩d效应量（AD Aβ+和MCI Aβ+组：3.02，AD Aβ+组：3.56，MCI Aβ+组：2.34），并且在HC Aβ-组和AD Aβ+组之间具有最高的曲线下面积（AUC）（AUC：0.983，95%置信区间：0.978-0.998）。
结论
PERSI-WM可以减轻PVE的影响并改善F-AV-45图像的半定量分析；因此，它可用于核医学领域的大规模临床应用。
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