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评估 10 分钟注射后 11C-PiB PET 与认知健康、轻度受损或可能患有阿尔茨海默病的老年人的 18F-FDG PET 的相关性。

Evaluation of 10-minute post-injection 11C-PiB PET and its correlation with 18F-FDG PET in older adults who are cognitively healthy, mildly impaired, or with probable Alzheimer's disease.

机构信息

Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Centro de Investigação Translacional em Oncologia, Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

Laboratório de Medicina Nuclear (LIM 43), Departamento de Radiologia e Oncologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

出版信息

Braz J Psychiatry. 2022 Aug 15;44(5):495-506. doi: 10.47626/1516-4446-2021-2374.

Abstract

OBJECTIVE

Positron emission tomography (PET) allows in vivo evaluation of molecular targets in neurodegenerative diseases, such as Alzheimer's disease. Mild cognitive impairment is an intermediate stage between normal cognition and Alzheimer-type dementia. In vivo fibrillar amyloid-beta can be detected in PET using [11C]-labeled Pittsburgh compound B (11C-PiB). In contrast, [18F]fluoro-2-deoxy-d-glucose (18F-FDG) is a neurodegeneration biomarker used to evaluate cerebral glucose metabolism, indicating neuronal injury and synaptic dysfunction. In addition, early cerebral uptake of amyloid-PET tracers can determine regional cerebral blood flow. The present study compared early-phase 11C-PiB and 18F-FDG in older adults without cognitive impairment, amnestic mild cognitive impairment, and clinical diagnosis of probable Alzheimer's disease.

METHODS

We selected 90 older adults, clinically classified as healthy controls, with amnestic mild cognitive impairment, or with probable Alzheimer's disease, who underwent an 18F-FDG PET, early-phase 11C-PiB PET and magnetic resonance imaging. All participants were also classified as amyloid-positive or -negative in late-phase 11C-PiB. The data were analyzed using statistical parametric mapping.

RESULTS

We found that the probable Alzheimer's disease and amnestic mild cognitive impairment group had lower early-phase 11C-PiB uptake in limbic structures than 18F-FDG uptake. The images showed significant interactions between amyloid-beta status (negative or positive). However, early-phase 11C-PiB appears to provide different information from 18F-FDG about neurodegeneration.

CONCLUSIONS

Our study suggests that early-phase 11C-PiB uptake correlates with 18F-FDG, irrespective of the particular amyloid-beta status. In addition, we observed distinct regional distribution patterns between both biomarkers, reinforcing the need for more robust studies to investigate the real clinical value of early-phase amyloid-PET imaging.

摘要

目的

正电子发射断层扫描(PET)可用于评估神经退行性疾病(如阿尔茨海默病)的分子靶点。轻度认知障碍是正常认知和阿尔茨海默病型痴呆之间的中间阶段。在 PET 中,可以使用[11C]标记的匹兹堡化合物 B(11C-PiB)检测活体内纤维状淀粉样β。相比之下,[18F]氟-2-脱氧-d-葡萄糖(18F-FDG)是一种用于评估大脑葡萄糖代谢的神经退行性生物标志物,可指示神经元损伤和突触功能障碍。此外,淀粉样蛋白-PET 示踪剂的早期脑摄取可确定局部脑血流。本研究比较了无认知障碍、遗忘型轻度认知障碍和临床诊断为可能的阿尔茨海默病的老年人中早期 11C-PiB 和 18F-FDG。

方法

我们选择了 90 名老年人,根据临床分类为健康对照者、遗忘型轻度认知障碍者或可能的阿尔茨海默病患者,他们接受了 18F-FDG PET、早期 11C-PiB PET 和磁共振成像检查。所有参与者也根据晚期 11C-PiB 分类为淀粉样蛋白阳性或阴性。使用统计参数映射对数据进行分析。

结果

我们发现,可能的阿尔茨海默病和遗忘型轻度认知障碍组在边缘结构中的早期 11C-PiB 摄取低于 18F-FDG 摄取。图像显示淀粉样蛋白-β状态(阴性或阳性)之间存在显著的相互作用。然而,早期 11C-PiB 似乎提供了与 18F-FDG 不同的神经退行性变信息。

结论

我们的研究表明,早期 11C-PiB 摄取与 18F-FDG 相关,无论特定的淀粉样蛋白-β状态如何。此外,我们观察到这两种生物标志物之间存在不同的区域分布模式,这加强了需要进行更有力的研究来探索早期淀粉样蛋白-PET 成像的真正临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d69d/9561831/9b4ed63b2bfb/bjp-44-05-495-g001.jpg

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