Department of Nuclear Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea.
Department of Nuclear Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea.
Neuroimage Clin. 2021;31:102773. doi: 10.1016/j.nicl.2021.102773. Epub 2021 Jul 24.
This study investigated changes in brain perfusion and Aβ burden according to the progression of Alzheimer's disease (AD) by using a dual-phase F-florbetaben (FBB) PET protocol.
Sixty subjects, including 12 with Aβ-negative normal cognition (AβNC), 32 with Aβ-positive mild cognitive impairment (AβMCI), and 16 with Aβ-positive AD (AβAD), were enrolled. A dynamic PET scan was obtained in the early phase (0-10 min, eFBB) and delayed phase (90-110 min, dFBB), which were then averaged into a single frame, respectively. In addition to the averaged eFBB, an R1 parametric map was calculated from the eFBB scan based on a simplified reference tissue model (SRTM). Between-group regional and voxel-wise analyses of the images were performed. The associations between cognitive profiles and PET-derived parameters were investigated.
Both the R1 and eFBB perfusion reductions in the cortical regions were not significantly different between the AβNC and AβMCI groups, while they were significantly reduced from the AβMCI to AβAD groups in regional and voxel-wise analyses. However, cortical Aβ depositions on dFBB were not significantly different between the AβMCI and AβAD groups. There were strong positive correlations between the R1 and eFBB images in regional and voxel-wise analyses. Both perfusion components showed significant correlations with general and specific cognitive profiles.
The results of this study demonstrated the feasibility of dual-phase F-FBB PET to evaluate different trajectories of dual biomarkers for neurodegeneration and Aβ burden over the course of AD. In addition, both eFBB and SRTM-based R1 can provide robust indices of brain perfusion.
本研究通过使用双期 F-氟比洛芬（FBB）PET 方案，研究了阿尔茨海默病（AD）进展过程中脑灌注和 Aβ 负担的变化。
纳入 60 名受试者，包括 12 名 Aβ 阴性正常认知（AβNC）、32 名 Aβ 阳性轻度认知障碍（AβMCI）和 16 名 Aβ 阳性 AD（AβAD）。获得了早期相（0-10 分钟，eFBB）和延迟相（90-110 分钟，dFBB）的动态 PET 扫描，然后分别将其平均为单个帧。除了平均 eFBB 外，还根据简化参考组织模型（SRTM）从 eFBB 扫描中计算了 R1 参数图。对图像进行了组间区域和体素分析。研究了认知特征与 PET 衍生参数之间的相关性。
皮质区域的 R1 和 eFBB 灌注减少在 AβNC 和 AβMCI 组之间没有显著差异，而在区域和体素分析中，从 AβMCI 到 AβAD 组显著减少。然而，在 AβMCI 和 AβAD 组之间，dFBB 上的皮质 Aβ 沉积没有显著差异。在区域和体素分析中，R1 和 eFBB 图像之间存在强烈的正相关。两种灌注成分均与一般和特定认知特征显著相关。
本研究结果表明，双期 F-FBB PET 用于评估 AD 过程中神经退行性变和 Aβ 负担的双生物标志物的不同轨迹是可行的。此外，eFBB 和基于 SRTM 的 R1 都可以提供大脑灌注的可靠指标。
