Wu Cheng-Han, Lu Yueh-Hsun, Lee Tse-Hao, Tu Chun-Yuan, Fuh Jong-Ling, Wang Yuh-Feng, Yang Bang-Hung
Department of Radiology, Taipei Medical University-Shuang Ho Hospital, New Taipei.
Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei.
Quant Imaging Med Surg. 2023 Aug 1;13(8):4806-4815. doi: 10.21037/qims-23-58. Epub 2023 Jun 14.
F-florbetaben (FBB) positron emission tomography (PET) scan has been widely used in research and routine clinical practice. Most studies used late-phase (scanning from 90 to 110 min after injection) FBB scans to generate beta-amyloid accumulation data. The feasibility of middle-phase scan is seldom discussed. Using the middle-phase data can shorten the patients' waiting between the injection and scan, and hospital can acquire more flexible schedule of routine scan.
Paired middle-phase (60-80 min) FBB scans and standard (90-110 min) FBB scans were obtained from 27 subjects (12 neurodegenerative dementia, 8 mild cognitive impairment, 3 normal control, and 4 patients not suffering from neurodegenerative dementia). Standardized uptake value ratios (SUVRs) were calculated and converted to centiloid (CL) scale to investigate the impact on image quantification. CL pipeline validation were performed to build an equation converting the middle-phase data into equivalent standard scans. Cohen's kappa of binary interpretation and brain amyloid plaque load (BAPL) score were also used to evaluate the intrareader agreement of the FBB image from the two protocols.
The middle-phase FBB SUVR showed an excellent correlation, which provided a linear regression equation of SUVR = 0.88 × SUVR + 0.07, with R=0.98. The slope of the equation indicated that there was bias between the middle and standard acquisition. This can be converted into the CL scale using CL = 174.68 × SUVR - 166.39. Cohen's kappa of binary interpretation and BAPL score were 1.0 (P<0.0001).
Our findings indicate that the middle-phase FBB protocol is feasible in clinical applications for scans that are at either end of beta-amyloid spectrum, which provides comparable semiquantitative results to standard scan. Patient's waiting time between the injection and scan can be shortened.
F-氟贝他班（FBB）正电子发射断层扫描（PET）已广泛应用于研究和临床常规实践。大多数研究使用晚期（注射后90至110分钟扫描）FBB扫描来生成β-淀粉样蛋白积累数据。很少有人讨论中期扫描的可行性。使用中期数据可以缩短患者注射与扫描之间的等待时间，医院也可以获得更灵活的常规扫描时间表。
从27名受试者（12例神经退行性痴呆、8例轻度认知障碍、3例正常对照和4例非神经退行性痴呆患者）中获取配对的中期（60 - 80分钟）FBB扫描和标准（90 - 110分钟）FBB扫描。计算标准化摄取值比率（SUVRs）并转换为百分位数（CL）量表，以研究对图像定量的影响。进行CL管道验证以建立将中期数据转换为等效标准扫描的方程。还使用二元解释的Cohen's kappa和脑淀粉样斑块负荷（BAPL）评分来评估两种方案的FBB图像在阅片者内的一致性。
中期FBB SUVR显示出极好的相关性，提供了SUVR = 0.88×SUVR + 0.07的线性回归方程，R = 0.98。该方程的斜率表明中期和标准采集之间存在偏差。使用CL = 174.68×SUVR - 166.39可将其转换为CL量表。二元解释的Cohen's kappa和BAPL评分均为1.0（P < 0.0001）。
我们的研究结果表明，中期FBB方案在β-淀粉样蛋白谱两端的扫描临床应用中是可行的，可提供与标准扫描相当的半定量结果。可以缩短患者注射与扫描之间的等待时间。
