Nuclear Medicine and Molecular Imaging, Imaging and Pathology, KU Leuven, Leuven, Belgium.
Division of Nuclear Medicine, University Hospitals UZ Leuven, Leuven, Belgium.
BMC Med Imaging. 2024 Feb 12;24(1):41. doi: 10.1186/s12880-024-01224-5.
F-FDG brain PET is clinically used for differential diagnosis in cognitive dysfunction of unclear etiology and for exclusion of a neurodegenerative cause in patients with cognitive impairment in late-life psychiatric disorders. F-FDG PET measures regional glucose metabolism, which represents a combination of neuronal/synaptic activity but also astrocytic activity and neuroinflammation. Recently, imaging of synaptic vesicle protein 2 A (SV2A) has become available and was shown to be a proxy of synaptic density. This prospective study will investigate the use of F-SynVesT-1 for imaging SV2A and its discriminative power for differential diagnosis in cognitive disorders in a head-to-head comparison to F-FDG PET. In addition, simultaneous PET/MR allows an evaluation of contributing factors and the additional value of advanced MRI imaging to FDG/SV2A PET imaging will be investigated. In this work, the study design and protocol are depicted.
In this prospective, multimodal imaging study, 110 patients with uncertain diagnosis of cognitive impairment who are referred for F-FDG PET brain imaging in their diagnostic work-up in a tertiary memory clinic will be recruited. In addition, 40 healthy volunteers (HV) between 18 and 85 years (M/F) will be included. All study participants will undergo simultaneous F-SynVesT-1 PET/MR and an extensive neuropsychological evaluation. Amyloid status will be measured by PET using FNAV4694, in HV above 50 years of age. Structural T1-weighted and T2-weighted fluid-attenuated inversion recovery MR images, triple-tagging arterial spin labeling (ASL) and resting-state functional MRI (rs-fMRI) will be obtained. The study has been registered on ClinicalTrials.gov (NCT05384353) and is approved by the local Research Ethics Committee.
The main endpoint of the study will be the comparison of the diagnostic accuracy between F-SynVesT-1 and F-FDG PET in cognitive disorders with uncertain etiology and in exclusion of a neurodegenerative cause in patients with cognitive impairment in late-life psychiatric disorders. The strength of the relationship between cognition and imaging data will be assessed, as well as the potential incremental diagnostic value of including MR volumetry, ASL perfusion and rs-fMRI.
18F-FDG 脑 PET 临床用于不明病因认知功能障碍的鉴别诊断，以及排除晚年精神障碍认知障碍患者的神经退行性病因。18F-FDG PET 测量区域葡萄糖代谢，它代表神经元/突触活性的组合，但也代表星形胶质细胞活性和神经炎症。最近，突触囊泡蛋白 2A（SV2A）的成像已经可用，并被证明是突触密度的替代物。这项前瞻性研究将调查使用 F-SynVesT-1 进行 SV2A 成像，并与 18F-FDG PET 成像进行头对头比较，以评估其在认知障碍中的鉴别诊断能力。此外，同时进行 PET/MR 允许评估促成因素，并且将研究高级 MRI 成像对 FDG/SV2A PET 成像的附加价值。在这项工作中，描绘了研究设计和方案。
在这项前瞻性、多模态成像研究中，将招募 110 名在三级记忆诊所进行诊断工作时因不确定认知障碍诊断而接受 18F-FDG 脑 PET 成像的患者。此外，还将招募 40 名 18-85 岁之间的健康志愿者（HV）。所有研究参与者将接受 F-SynVesT-1 PET/MR 同时检查和广泛的神经心理学评估。在 HV 中，年龄大于 50 岁时，将使用 FNAV4694 通过 PET 测量淀粉样蛋白状态。将获得结构 T1 加权和 T2 加权液体衰减反转恢复磁共振成像、三重标记动脉自旋标记（ASL）和静息状态功能磁共振成像（rs-fMRI）。该研究已在 ClinicalTrials.gov 上注册（NCT05384353），并获得当地研究伦理委员会的批准。
该研究的主要终点将是比较 F-SynVesT-1 和 18F-FDG PET 在病因不明的认知障碍中的诊断准确性，以及在排除晚年精神障碍认知障碍患者的神经退行性病因中的诊断准确性。将评估认知与成像数据之间的关系强度，以及包括磁共振容积成像、ASL 灌注和 rs-fMRI 在内的潜在增量诊断价值。
