Journal
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Volume 50, Issue 5, Pages 1384-1394Publisher
SPRINGER
DOI: 10.1007/s00259-022-06087-y
Keywords
Neuroimaging; Perfusion phase; [F-18]PI-2620; [F-18]Flutemetamol
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The purpose of this study was to compare [F-18]flutemetamol-amyloid-PET and [F-18]PI-2620 tau-PET as dual-purpose tracers for the detection of neurodegenerative disease. The results showed that the perfusion-weighted images of both tracers had high correlations across the brain, especially in the frontal and parietal lobes, which were the regions with pronounced perfusion deficit in the patient group. Therefore, both tracers may serve for two diagnostic channels by assessing amyloid/tau status and neuronal activity.
Purpose Characteristic features of amyloid-PET (A), tau-PET (T), and FDG-PET (N) can serve for the A/T/N classification of neurodegenerative diseases. Recent studies showed that the early, perfusion-weighted phases of amyloid- or tau-PET recordings serve to detect cerebrometabolic deficits equally to FDG-PET, therefore providing a surrogate of neuronal injury. As such, two channels of diagnostic information can be obtained in the setting of a single PET scan. However, there has hitherto been no comparison of early-phase amyloid- and tau-PET as surrogates for deficits in perfusion/metabolism. Therefore, we undertook to compare [F-18]flutemetamol-amyloid-PET and [F-18]PI-2620 tau-PET as one-stop shop dual purpose tracers for the detection of neurodegenerative disease. Methods We obtained early-phase PET recordings with [F-18]PI-2620 (0.5-2.5 min p.i.) and [F-18]flutemetamol (0-10 min p.i.) in 64 patients with suspected neurodegenerative disease. We contrasted global mean normalized images (SUVr) in the patients with a normal cohort of 15 volunteers without evidence of increased pathology to beta-amyloid- and tau-PET examinations. Regional group differences of tracer uptake (z-scores) of 246 Brainnetome volumes of interest were calculated for both tracers, and the correlations of the z-scores were evaluated using Pearson's correlation coefficient. Lobar compartments, regions with significant neuronal injury (z-scores < - 3), and patients with different neurodegenerative disease entities (e.g., Alzheimer's disease or 4R-tauopathies) served for subgroup analysis. Additionally, we used partial regression to correlate regional perfusion alterations with clinical scores in cognition tests. Results The z-scores of perfusion-weighted images of both tracers showed high correlations across the brain, especially in the frontal and parietal lobes, which were the brain regions with pronounced perfusion deficit in the patient group (R = 0.83 & PLUSMN; 0.08; range, 0.61-0.95). Z-scores of individual patients correlated well by region (R = 0.57 & PLUSMN; 0.15; range, 0.16-0.90), notably when significant perfusion deficits were present (R = 0.66 & PLUSMN; 0.15; range, 0.28-0.90). Conclusion The early perfusion phases of [F-18]PI-2620 tau- and [F-18]flutemetamol-amyloid-PET are roughly equivalent indices of perfusion defect indicative of regional and lobar neuronal injury in patients with various neurodegenerative diseases. As such, either tracer may serve for two diagnostic channels by assessment of amyloid/tau status and neuronal activity.
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