Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Institute of Biomedical Engineering, School of Life Science, Shanghai University, Shanghai, China.
Eur Radiol. 2023 Jul;33(7):4567-4579. doi: 10.1007/s00330-023-09571-7. Epub 2023 Apr 26.
Quantification of tau accumulation using positron emission tomography (PET) is critical for the diagnosis of Alzheimer's disease (AD). This study aimed to evaluate the feasibility of F-florzolotau quantification in patients with AD using a magnetic resonance imaging (MRI)-free tau PET template, since individual high-resolution MRI is costly and not always available in practice.
F-florzolotau PET and MRI scans were obtained in a discovery cohort including (1) patients within the AD continuum (n = 87), (2) cognitively impaired patients with non-AD (n = 32), and (3) cognitively unimpaired subjects (n = 26). The validation cohort comprised 24 patients with AD. Following MRI-dependent spatial normalization (standard approach) in randomly selected subjects (n = 40) to cover the entire spectrum of cognitive function, selected PET images were averaged to create the F-florzolotau-specific template. Standardized uptake value ratios (SUVRs) were calculated in five predefined regions of interest (ROIs). MRI-free and MRI-dependent methods were compared in terms of continuous and dichotomous agreement, diagnostic performances, and associations with specific cognitive domains.
MRI-free SUVRs had a high continuous and dichotomous agreement with MRI-dependent measures for all ROIs (intraclass correlation coefficient ≥ 0.980; agreement ≥ 94.5%). Similar findings were observed for AD-related effect sizes, diagnostic performances with respect to categorization across the cognitive spectrum, and associations with cognitive domains. The robustness of the MRI-free approach was confirmed in the validation cohort.
The use of an F-florzolotau-specific template is a valid alternative to MRI-dependent spatial normalization, improving the clinical generalizability of this second-generation tau tracer.
• Regional F-florzolotau SUVRs reflecting tau accumulation in the living brains are reliable biomarkers for the diagnosis, differential diagnosis, and assessment of disease severity in patients with AD. • The F-florzolotau-specific template is a valid alternative to MRI-dependent spatial normalization, improving the clinical generalizability of this second-generation tau tracer.
使用正电子发射断层扫描（PET）定量检测 tau 蛋白的聚集对于阿尔茨海默病（AD）的诊断至关重要。本研究旨在评估在无磁共振成像（MRI）的 tau PET 模板的情况下，使用 F-florzolotau 定量检测 AD 患者 tau 蛋白的可行性，因为个体化高分辨率 MRI 成本高，在实际中并不总是可用。
在包括（1）AD 连续体患者（n=87）、（2）认知障碍非 AD 患者（n=32）和（3）认知正常受试者（n=26）的发现队列中获得 F-florzolotau PET 和 MRI 扫描。验证队列由 24 例 AD 患者组成。在随机选择的受试者（n=40）中进行基于 MRI 的空间标准化（标准方法）以覆盖整个认知功能谱后，选择 PET 图像进行平均以创建 F-florzolotau 特异性模板。在五个预设感兴趣区域（ROI）中计算标准化摄取值比（SUVr）。比较了 MRI 自由和 MRI 依赖方法在连续和二分法一致性、诊断性能以及与特定认知领域的相关性方面的差异。
对于所有 ROI（组内相关系数≥0.980；一致性≥94.5%），MRI 自由 SUVr 与 MRI 依赖测量具有高度的连续和二分法一致性。在 AD 相关的效应大小、在认知谱的分类方面的诊断性能以及与认知领域的相关性方面，也观察到了类似的发现。在验证队列中，MRI 自由方法的稳健性得到了确认。
使用 F-florzolotau 特异性模板是 MRI 依赖空间标准化的有效替代方法，可提高第二代 tau 示踪剂的临床推广性。
在活脑中反映 tau 蛋白聚集的区域性 F-florzolotau SUVr 是 AD 患者诊断、鉴别诊断和疾病严重程度评估的可靠生物标志物。
F-florzolotau 特异性模板是 MRI 依赖空间标准化的有效替代方法，可提高第二代 tau 示踪剂的临床推广性。
