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. 2018;65(1):89-97.
doi: 10.3233/JAD-180274.

Can 11C-PiB-PET Relative Delivery R1 or 11C-PiB-PET Perfusion Replace 18F-FDG-PET in the Assessment of Brain Neurodegeneration?

Francisco P M Oliveira  1   2 , Ana Paula Moreira  3 , Alexandre de Mendonça  4 , Ana Verdelho  5 , Carolina Xavier  1 , Dalila Barroca  1 , Joana Rio  1 , Eva Cardoso  1 , Ângela Cruz  1 , Antero Abrunhosa  1 , Miguel Castelo-Branco  1   2
Affiliations

Can 11C-PiB-PET Relative Delivery R1 or 11C-PiB-PET Perfusion Replace 18F-FDG-PET in the Assessment of Brain Neurodegeneration?

Francisco P M Oliveira et al. J Alzheimers Dis. 2018.

Abstract

Background: Pittsburgh Compound B (PiB) positron emission tomography (PET) is used to visualize in vivo amyloid plaques in the brain. Frequently the PiB examinations are complemented with a fluorodeoxyglucose (FDG) PET scan to further assess neurodegeneration.

Objective: Our goal is to identify alternative correlates of FDG images by assessing which kinetic methods originate PiB derived relative delivery ratio (R1) images that can be correlated with the FDG images, and to compare them with PiB perfusion (pPiB) images obtained from the early-phase of PiB acquisition.

Methods: We selected 52 patients with cognitive impairment who underwent a dynamic PiB and FDG acquisitions. To compute the R1 images, two simplified reference tissue models (SRTM and SRTM2) and two multi-linear reference tissue models (MRTM and MRTM2) were used. The pPiB images were obtained in two different time intervals.

Results: All six types of images were of good quality and highly correlated with the FDG images (mean voxelwise within-subjects r > 0.92). The higher correlation was found for FDG-R1(MRTM). Regarding the voxelwise regional correlation, the higher mean all brain correlations was r = 0.825 for FDG-R1(MRTM) and statistically significant in the whole brain analysis.

Conclusion: All R1 and pPiB images here tested have potential to assess the metabolic impact of neurodegeneration almost as reliably as the FDG images. However, this is not enough to validate these images for a single-subject analysis compared with the FDG image, and thus they cannot yet be used clinically to replace the FDG image before such evaluation.

Keywords: 11C-PIB; 18F-FDG; Alzheimer’s disease; compartmental models; neurodegeneration; perfusion.

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Figures

Fig. 1
Fig. 1
Two-tissue compartment model with reference region. CF+NS is the concentration due to free and nonspecific binding, CS is the concentration due to specific binding.
Fig. 2
Fig. 2
Boxplot graph comparing the within subjects correlation coefficient between the FDG images and the R1(SRTM), R1(SRTM2), R1(MRTM), R1(MRTM2), pPiB(0– 6min) and pPiB(1– 8min) images.
Fig. 3
Fig. 3
Two examples of the FDG, pPiB(1– 8min), and R1(MRTM) images, respectively from the left to the right. The images on the top are from a patient with AD, and on the bottom from a patient with FTD. In the top there is an asymmetric uptake in the parietal cortex and on the bottom an asymmetric uptake in the frontal cortex. These patterns can be seen in the three types of images.
Fig. 4
Fig. 4
Mean voxelwise correlation between the set of FDG images and the correspondent set of R1(MRTM) images. The correlation image is overlapping the template MRI image.
See this image and copyright information in PMC

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