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tau 正电子发射断层扫描在认知障碍和疑似阿尔茨海默病患者中的应用。

Tau positron emission tomography in patients with cognitive impairment and suspected Alzheimer's disease.

机构信息

Department of Biofunctional Imaging, Fukushima Medical University.

Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University.

出版信息

Fukushima J Med Sci. 2023 Aug 10;69(2):85-93. doi: 10.5387/fms.2023-08. Epub 2023 Jun 10.

Abstract

Alzheimer's disease (AD) is diagnosed by the presence of both amyloid β and tau proteins. Recent advances in molecular PET imaging have made it possible to assess the accumulation of these proteins in the living brain. PET ligands have been developed that bind to 3R/4R tau in AD, but not to 3R tau or 4R tau alone. Of the first-generation PET ligands, F-flortaucipir has recently been approved by the Food and Drug Administration. Several second-generation PET probes with less off-target binding have been developed and are being applied clinically. Visual interpretation of tau PET should be based on neuropathological neurofibrillary tangle staging instead of a simple positive or negative classification. Four visual read classifications have been proposed: "no uptake," "medial temporal lobe (MTL) only," "MTL AND," and "outside MTL." As an adjunct to visual interpretation, quantitative analysis has been proposed using MRI-based native space FreeSurfer parcellations. The standardized uptake value ratio of the target area is measured using the cerebellar gray matter as a reference region. In the near future, the Centiloid scale of tau PET is expected to be used as a harmonized value for standardizing each analytical method or PET ligand used, similar to amyloid PET.

摘要

阿尔茨海默病(AD)的诊断依据是淀粉样蛋白β和 tau 蛋白的存在。近年来,分子 PET 成像技术的进步使得评估这些蛋白质在活脑中的积累成为可能。已经开发出了与 AD 中的 3R/4R tau 结合但不与 3R tau 或 4R tau 单独结合的 PET 配体。在第一代 PET 配体中,F-氟替卡滨最近已获得美国食品和药物管理局的批准。已经开发出几种具有较少脱靶结合的第二代 PET 探针,并正在临床中应用。tau PET 的视觉解读应该基于神经病理学神经纤维缠结分期,而不是简单的阳性或阴性分类。已经提出了四种视觉读取分类:“无摄取”、“内侧颞叶(MTL)仅”、“MTL AND”和“MTL 外”。作为视觉解释的辅助手段,已经提出了使用基于 MRI 的 native space FreeSurfer 分割进行定量分析。使用小脑灰质作为参考区域来测量目标区域的标准化摄取值比。在不久的将来,tau PET 的 Centiloid 量表有望作为一种协调值,用于标准化每种分析方法或使用的 PET 配体,类似于淀粉样蛋白 PET。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59b0/10480511/57de0a704975/2185-4610-69-085-g001.jpg

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