Comparison of qualitative and quantitative imaging characteristics of [11C]PiB and [18F]flutemetamol in normal control and Alzheimer's subjects
Comparison of qualitative and quantitative imaging characteristics of [11C]PiB and [18F]flutemetamol in normal control and Alzheimer's subjects
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DOI：
10.1016/j.nicl.2015.10.007
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发表时间：
2015-01-01
影响因子：
4.2
通讯作者：
Mathis, Chester A.
中科院分区：
文献类型：
--
作者：
Mountz, James M.;Laymon, Charles M.;Mathis, Chester A.
导语：神经性淀粉样斑块和神经原纤维缠结是阿尔茨海默病的标志性病理病变，被认为是在临床检测到脑衰竭症状之前发展起来的。能够检测到神经性淀粉样斑块存在的成像方法应该能够提高临床医生在早期症状阶段识别阿尔茨海默病的能力，并在症状前识别有风险的个体。目前研究最好的淀粉样蛋白成像配体是[C-11]Pittsburgh Compound B （[C-11]PiB）。然而，这种放射性示踪剂的20分钟半衰期限制了它的使用。本研究旨在评估[F-18]氟替他莫的性能特征，并在同一受试者中独立比较[C-11]PiB的结果。方法：23名受试者，15名认知正常（NL）， 8名临床诊断为阿尔茨海默氏痴呆症（AD），在研究入组后28天内进行了[C-11]PiB和[F-18]氟替他莫PET扫描。我们研究了正常和AD受试者，以评估淀粉样蛋白阳性范围内的摄取特征。盲法视觉阅读由五名评分员进行。在两种示踪剂的皮质SUVR之间以及每种示踪剂的评分与SUVR之间进行相关性分析。以SUVR分类为标准，确定每个示踪剂分类扫描为淀粉样蛋白阳性或阴性的总体阅读器准确性。结果：两种示踪剂的整体皮质SUVR的线性相关系数为R-2 = 0.85，表明两种示踪剂具有相似的保留特征。这两种示踪剂在相对确定的ad样阳性方面具有良好的相关性（Cohen kappa = 0.82）。在2/23 [C-11]PiB扫描和4/23 [F-18]氟替他莫扫描中，平均视觉评分和整体皮质SUVR的分类不一致。结论：[C-11] PiB和[F-18]氟替他莫在一系列淀粉样蛋白阴性和阳性受试者中具有相似的保留特性。当使用标准化视觉读取技术将扫描分类为淀粉样蛋白阳性或淀粉样蛋白阴性时，两种示踪剂的表现相似，并与SUVR分类良好相关。然而，在对淀粉样蛋白阳性区和淀粉样蛋白阴性区进行视觉解释时应注意，特别是在考虑皮层和白质保留的[F-18]氟替美莫的情况下。(C) 2015年作者。Elsevier Inc.出版。
Introduction: Neuritic amyloid plaques and neurofibrillary tangles, the hallmark pathologic lesions of Alzheimer's disease, are thought to develop before the symptoms of brain failure are clinically detectable. Imaging methods capable of detecting the presence of neuritic amyloid plaques should improve a clinician's ability to identify Alzheimer's disease during the earliest symptomatic phase and to identify at-risk individuals presymptomatically. Currently the best studied amyloid imaging ligand is [C-11]Pittsburgh Compound B ([C-11]PiB). However, the 20-minute half-life of this radiotracer limits its use. This study is designed to evaluate the performance characteristics of [F-18]flutemetamol and to independently compare results to [C-11]PiB in the same subjects.Methods: Twenty-three subjects, 15 cognitively normal (NL) and 8 with a clinical diagnosis of Alzheimer's Dementia (AD), underwent [C-11]PiB and [F-18]flutemetamol PET scans within 28 days of study enrollment. We studied both normal and AD subjects to assess the uptake characteristics across a range of amyloid positivity. Blinded visual reads were conducted by five raters. Correlation analyses were performed between cortical SUVR for the two tracers and also between rater scores and SUVR for each tracer. Overall reader accuracy for classifying scans as amyloid positive or negative was determined for each tracer using SUVR classification as the standard.Results: The linear correlation coefficient between global cortical SUVR for the two tracers was R-2 = 0.85, indicating that both tracers have similar retention characteristics. The two tracers were well correlated for rater-determined AD-like positivity (Cohen kappa = 0.82). Averaged visual ratings and global cortical SUVR disagreed on their classification in 2/23 [C-11]PiB scans and 4/23 [F-18]flutemetamol scans.Conclusions: [C-11] PiB and [F-18]flutemetamol have similar retention characteristics across a range of amyloid negative to positive subjects. Both tracers performed similarly when a standardized visual read technique was used to classify scans as amyloid-positive or amyloid-negative and correlated well with SUVR classifications. However, care in visual interpretation of amyloid positive versus amyloid negative regions should be taken, particularly in the case of [F-18]flutemetamol when considering cortical vs. white-matter retention. (C) 2015 The Authors. Published by Elsevier Inc.