123I-FP-CIT striatal binding ratios do not decrease significantly with age in older adults
123I-FP-CIT striatal binding ratios do not decrease significantly with age in older adults
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DOI：
10.1007/s12149-019-01352-x
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发表时间：
2019-06-01
影响因子：
2.6
通讯作者：
Thomas, Alan J.
中科院分区：
文献类型：
--
作者：
Roberts, Gemma;Lloyd, James J.;Thomas, Alan J.
目的 I-123-2-甲甲氧基-3-(4-碘苯基)-N-(3-氟丙基)去托烷 (FP-CIT) 成像是一种用于诊断路易体病的既定生物标志物。图像通常借助纹状体结合比 (SBR) 进行报告，通过 Z 分数将摄取量与正常数据库进行比较。众所周知，SBR 具有年龄依赖性。然而，之前的研究涵盖了 20 岁至 80 岁之间的广泛年龄范围，而不是关注老年人。通常报告呈线性关系，但一些作者认为，SBR 在老年时不会迅速下降。商业软件包通常会调整 SBR Z 分数以尝试补偿与年龄相关的下降，但所使用的模型各不相同。鉴于大多数转诊进行 FP-CIT 扫描的患者年龄超过 60 岁，确保年龄校正适合老年人非常重要。我们通过对 123 名 60 岁以上成年人进行研究扫描，研究了 SBR 与老年人年龄的关系以及年龄校正的效果。 方法 将 29 名健康老年人和 23 名因阿尔茨海默氏病而患有 MCI 的老年人作为对照，即没有路易体病证据的个体。他们的年龄从 60 岁到 92 岁不等（平均 76 岁；标准差 7.9）。 SBR 和 Z 分数使用 BRASS (Hermes Medical) 和 DaTQUANT (GE Healthcare) 计算。根据年龄和应用的线性混合效应模型绘制 SBR。我们使用 71 名患有痴呆症或轻度认知障碍的老年人的独立数据集测试了 BRASS 中删除年龄校正的效果。结果 SBR 与每年年龄之间的线性拟合斜率在 BRASS 中为 -0.007 (p=0.30)，在 DaTQUANT 中为 -0.004 (p=0.35)。斜率小于文献报道的斜率，并且与零相比没有统计学上的显着差异。在测试对象中关闭 BRASS 中的年龄校正后，80 岁时的 Z 评分降低了大约 1 个标准差。结论 我们发现，在 60 岁以上、无路易体病的成年人中，SBR 没有出现统计学上显着的年龄相关下降。应用固定年龄校正率的商业软件包可能对老年人的年龄进行过度校正，这可能导致误诊。
Objective I-123-2-Carbomethoxy-3-(4-iodophenyl)-N-(3-fluoropropyl)nortropane (FP-CIT) imaging is an established biomarker used in the diagnosis of Lewy body disease. Images are often reported with the aid of striatal binding ratios (SBRs), comparing uptake to a normal database via Z scores. It is well known that SBRs are age dependent. However, previous studies cover wide age ranges between 20 and 80 years, rather than focusing on older adults. Typically a linear relationship is reported, but some authors have suggested that SBRs do not decline as rapidly in old age. Commercial software packages usually adjust the SBR Z score to attempt to compensate for age-related decline, but the model used varies. Ensuring age correction is appropriate for older adults is important, given that the majority of patients referred for FP-CIT scans are aged over 60 years. We examined the relationship of SBR with age in older adults and the effect of age correction using research scans from 123 adults over 60 years of age.Methods Twenty-nine healthy older adults and twenty-three with MCI due to Alzheimer's disease were included as controls, i.e. individuals with no evidence of Lewy body disease. Their ages ranged from 60 to 92 years (mean 76; SD 7.9). SBRs and Z scores were calculated using BRASS (Hermes Medical) and DaTQUANT (GE Healthcare). SBRs were plotted against age and linear mixed effect models applied. We tested the effect of removing age correction in BRASS using an independent dataset of 71 older adults with dementia or mild cognitive impairment.Results The slopes of the linear fits between SBR and age per year were -0.007 (p=0.30) with BRASS and -0.004 (p=0.35) with DaTQUANT. The slopes are smaller than reported in the literature and show no statistically significant difference from zero. Switching age correction off in BRASS in the test subjects reduced Z scores by approximately 1 standard deviation at 80 years of age.Conclusion We found no statistically significant age-related decline in SBR in adults over 60years of age without Lewy body disease. Commercial software packages that apply a fixed rate of age correction may be overcorrecting for age in older adults, which could contribute to misdiagnosis.