In vivo [18F]-AV-1451 tau-PET imaging in sporadic Creutzfeldt-Jakob disease
In vivo [18F]-AV-1451 tau-PET imaging in sporadic Creutzfeldt-Jakob disease
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DOI：
10.1212/wnl.0000000000005064
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发表时间：
2018-03-06
期刊：
影响因子：
9.9
通讯作者：
Ances, Beau M.
中科院分区：
文献类型：
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作者：
Day, Gregory S.;Gordon, Brian A.;Ances, Beau M.
目的探讨经尸检证实的散发性克雅氏病（Creutzfeldt-Jakob disease，CJD）患者体内[F-18]-AV-1451 tau-PET的滞留模式（中位年龄，66岁[63-74]），并将结果与认知正常（CN）人进行比较（n = 44;中位年龄，68岁[63-74]）和极轻度阿尔茨海默病（AD）痴呆的参与者（n = 8;中位年龄，77岁[63-90]）。在所有CJD患者中完成尸检，确认临床诊断并允许表征AD神经病理学变化（ADNC）。结果所有CJD患者均表现为快速进展性痴呆，典型的磁共振脑成像变化和CSF总tau蛋白升高（中位数= 6，519;范围= 1，528 - 13，240 pg/mL）。死亡发生在症状发作后9个月内，从[F-18]-AV-1451 PET至尸检的中位间隔为1个月（0.2-3.3）。目视检查时未观察到[F-18]-AV-1451保留的独特模式。CJD患者（1.17，1.08-1.36）的标准化摄取值比值汇总与CN患者（1.14，0.84-1.54; p = 0.6）无法区分，且远低于AD患者（2.23，1.60-3.04; p 0.01）。CJD患者和CN患者的[F-18]-AV-1451保留在AD和CJD经常受累的脑区相似。神经病理学分析证实了所有患者的临床诊断为CJD。4例CJD患者也有低水平的ADNC（A1 B1 C 0）; 1例患者有中等水平的ADNC（A2 B2 C1/2）。[F-18]-AV-1451 PET示踪剂对与AD痴呆相关的成对螺旋tau丝保持良好的特异性。
ObjectiveTo determine whether specific patterns of [F-18]-AV-1451 tau-PET retention are observed in patients with autopsy-proven sporadic Creutzfeldt-Jakob disease (CJD).MethodsIn vivo [F-18]-AV-1451 PET neuroimaging was performed in 5 patients with sporadic CJD (median age, 66 years [63-74]), and results were compared to cognitively normal (CN) persons (n = 44; median age, 68 years [63-74]) and to participants with very mild Alzheimer disease (AD) dementia (n = 8; median age, 77 years [63-90]). Autopsy was completed in all patients with CJD, confirming the clinical diagnosis and permitting characterization of AD neuropathologic change (ADNC).ResultsAll patients with CJD presented with rapidly progressive dementia, typical magnetic resonance brain imaging changes, and elevated CSF total tau (median = 6,519; range = 1,528-13,240 pg/mL). Death occurred within 9 months of symptom onset, with a median 1 month (0.2-3.3) interval from [F-18]-AV-1451 PET to autopsy. No unique pattern of [F-18]-AV-1451 retention was observed on visual inspection. Summary standardized uptake value ratios in patients with CJD (1.17, 1.08-1.36) were indistinguishable from CN persons (1.14, 0.84-1.54; p = 0.6), and well below those of participants with AD (2.23, 1.60-3.04; p 0.01). [F-18]-AV-1451 retention in patients with CJD and CN persons was similar in brain areas frequently affected in AD and CJD. Neuropathologic analysis confirmed the clinical diagnosis in all patients with CJD. Four patients with CJD also had low-level ADNC (A1B1C0); one patient had intermediate-level ADNC (A2B2C1/2).ConclusionIncreased [F-18]-AV-1451 retention was not observed in patients with rapidly progressive dementia due to sporadic CJD. The [F-18]-AV-1451 PET tracer maintains good specificity for paired helical tau filaments associated with AD dementia.