Optimal Acquisition Time Window and Simplified Quantification of Dopamine Transporter Availability Using 18F-FE-PE2I in Healthy Controls and Parkinson Disease Patients
Optimal Acquisition Time Window and Simplified Quantification of Dopamine Transporter Availability Using 18F-FE-PE2I in Healthy Controls and Parkinson Disease Patients
复制标题
DOI：
10.2967/jnumed.115.171231
复制
发表时间：
2016-10-01
影响因子：
9.3
通讯作者：
Varrone, Andrea
中科院分区：
文献类型：
--
作者：
Sonni, Ida;Fazio, Patrik;Varrone, Andrea
F-18-（E）-N-（3-碘丙-2-烯基）-2 β-碳氟乙氧基-3 β-（4 '甲基苯基）去甲托烷（F-18-FE-PE 2 I）是一种新开发的多巴胺转运蛋白（DAT）PET放射性配体。完全定量方法依赖于F-18-FE-PE 2 I的动态采集，但在临床环境中，简化的方案是优选的。本研究的目的是确定F-18-FE-PE 2 I的最佳采集时间窗口，并验证特异性结合率（SBR）作为一种简化的定量方法。方法：10例帕金森病（PD）患者和10例正常对照者。使用高分辨率研究断层扫描仪（HRRT），使用F-18-FE-PE 2 I进行了93分钟的动态PET测量。动态测量也被平滑到临床PET系统（HR）的分辨率。尾状核、壳核、腹侧纹状体、黑质（SN）和小脑的感兴趣区域在共配准的MR图像上手动绘制。结果测量是SBR，金标准是用小波辅助参数成像（WAPI BPND）获得的结合电位。小脑被用作参考区域。在初步分析中，计算了8个时间窗口（SBRdyn）的SBR。线性回归分析和Bland-Altman图用于选择最佳采集时间窗。创建来自所选时间窗口的平均图像，从中计算新的SBR值（在HRRT上的平均图像上计算的SBR和在模拟HR图像上的平均图像上计算的SBR），并与WAPI BPND进行比较。计算效应量。结果：16.5 ~ 42 min时间窗的SBRdyn值与WAPI BPND相关性最好（r（2）= 0.98，P < 0.001）。SBRHR与WAPI-BPND显著相关（P < 0.001）（对照组r（2）= 0.95，PD组r（2）= 0.97）。在纹状体中，SBRHR值在对照组中比BPND低37%，在PD患者中低29%，而在SN中，对照组中低估22%，在PD患者中低估15%。在尾状核（0.6）、壳核（1.7和1.4）、腹侧纹状体（0.7）和SN（0.5和0.4）中发现了BPND和SBRHR的相似效应量。结论：16.5 - 42 min之间的单次F-18-FE-PE 2 I采集为简化DAT定量提供了最佳结局指标。尽管低估了BPND，但SBR可以在临床环境中用作使用F-18-FE-PE 2 I的DAT的有效定量方法，因为它提供了与对照和PD患者之间的BPND类似的区分。
F-18-(E)-N-(3-iodoprop-2-enyl)-2 beta-carbofluoroethoxy-3 beta-(4'methylphenyl)nortropane (F-18-FE-PE2I) is a newly developed dopamine transporter (DAT) PET radioligand. Full quantification methods rely on dynamic acquisition of F-18-FE-PE2I, but in a clinical setting a simplified protocol is preferable. The aims of this study were to identify the optimal acquisition time window for F-18-FE-PE2I and to validate the specific binding ratio (SBR) as a simplified quantification method. Methods: Ten Parkinson disease (PD) patients and 10 controls were included. Ninety-three-min dynamic PET measurements with F-18-FE-PE2I were conducted using the high-resolution research tomograph (HRRT). The dynamic measurement was also smoothed to the resolution of a clinical PET system (HR). Regions of interest for the caudate, putamen, ventral striatum, substantia nigra (SN), and cerebellum were manually drawn on coregistered MR images. The outcome measure was the SBR, and the gold standard was the binding potential obtained with wavelet-aided parametric imaging (WAPI BPND). The cerebellum was used as a reference region. In a preliminary analysis, SBR was computed for 8 time windows (SBRdyn). Linear regression analysis and Bland-Altman plots were used to select the optimal acquisition time window. An average image from the selected time window was created, from which new SBR values (SBR calculated on the average image on the HRRT and SBR calculated on the average image on the simulated HR images) were calculated and compared with WAPI BPND. The effect size was calculated. Results: SBRdyn values for the time window between 16.5 and 42 min correlated best with WAPI BPND (r(2) = 0.98, P < 0.001). Significant correlations (P < 0.001) were observed between SBRHR and WAPI-BPND (r(2) = 0.95 in controls and 0.97 in PD patients). In the striatum, SBRHR values were 37% lower than BPND in controls, 29% in PD patients, whereas in the SN the underestimation was 22% in controls and 15% in PD patients. Similar effect sizes for BPND and SBRHR were found in the caudate (0.6), putamen (1.7 and 1.4), ventral striatum (0.7), and SN (0.5 and 0.4). Conclusion: A single F-18-FE-PE2I acquisition between 16.5 and 42 min provides the best outcome measure for simplified DAT quantification. Despite underestimation of the BPND, the SBR can be used in a clinical setting as a valid quantification method for DAT using F-18-FE-PE2I, because it provides differentiation similar to BPND between controls and PD patients.