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A simulation study on the impact of the blood flow-dependent component in [18F]AV45 SUVR in Alzheimer's disease.
PLoS One. 2017; 12(12):e0189155.Plos

Abstract

BACKGROUND

Increased brain uptake on [18F]AV45 PET is a biomarker for Alzheimer's disease (AD). The standardised uptake value ratio (SUVR) is widely used for quantification but is subject to variability. Here we evaluate how SUVR of a cortical target region is affected by blood flow changes in the target and two frequently used reference regions.

METHODS

Regional baseline time-activity curves (TACs) were simulated based on metabolite-corrected plasma input functions and pharmacokinetic parameters obtained from our previously acquired data in healthy control (HC; n = 10), amnestic mild cognitive impairment (aMCI; n = 15) and AD cohorts (n = 9). Blood flow changes were simulated by altering the regional tracer delivery rate K1 (and clearance rate k2) between -40% and +40% from its regional baseline value in the target region and/or cerebellar grey (CB) or subcortical white matter (WM) reference regions. The corresponding change in SUVR was calculated at 50-60 min post-injection.

RESULTS

A -40% blood flow reduction in the target resulted in an increased SUVRtarget (e.g. SUVRprecuneus: +10.0±5% in HC, +2.5±2% in AD), irrespective of the used reference region. A -40% blood flow reduction in the WM reference region increased SUVRWM (+11.5±4% in HC, +13.5±3% in AD) while a blood flow reduction in CB decreased SUVRCB (-9.5±6% in HC, -5.5±2% in AD), irrespective of the used target region. A -40% flow reduction in both the precuneus and reference WM (i.e., global flow change) induced an increased SUVR (+22.5±8% in HC, +16.0±4% in AD). When considering reference CB instead, SUVR was decreased by less than -5% (both in HC and AD).

CONCLUSION

Blood flow changes introduce alterations in [18F]AV45 PET SUVR. Flow reductions in the CB and WM reference regions resulted in a decreased and increased SUVR of the target, respectively. SUVR was more affected by global blood flow changes when considering WM instead of CB normalization.

Authors+Show Affiliations

Molecular Imaging Center Antwerp, University of Antwerp, Antwerp, Belgium.Molecular Imaging Center Antwerp, University of Antwerp, Antwerp, Belgium.Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium.Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium. Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Hoge Beuken en Middelheim, Antwerp, Belgium.Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium.Molecular Imaging Center Antwerp, University of Antwerp, Antwerp, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29211812

Citation

Ottoy, Julie, et al. "A Simulation Study On the Impact of the Blood Flow-dependent Component in [18F]AV45 SUVR in Alzheimer's Disease." PloS One, vol. 12, no. 12, 2017, pp. e0189155.
Ottoy J, Verhaeghe J, Niemantsverdriet E, et al. A simulation study on the impact of the blood flow-dependent component in [18F]AV45 SUVR in Alzheimer's disease. PLoS ONE. 2017;12(12):e0189155.
Ottoy, J., Verhaeghe, J., Niemantsverdriet, E., Engelborghs, S., Stroobants, S., & Staelens, S. (2017). A simulation study on the impact of the blood flow-dependent component in [18F]AV45 SUVR in Alzheimer's disease. PloS One, 12(12), e0189155. https://doi.org/10.1371/journal.pone.0189155
Ottoy J, et al. A Simulation Study On the Impact of the Blood Flow-dependent Component in [18F]AV45 SUVR in Alzheimer's Disease. PLoS ONE. 2017;12(12):e0189155. PubMed PMID: 29211812.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A simulation study on the impact of the blood flow-dependent component in [18F]AV45 SUVR in Alzheimer's disease. AU - Ottoy,Julie, AU - Verhaeghe,Jeroen, AU - Niemantsverdriet,Ellis, AU - Engelborghs,Sebastiaan, AU - Stroobants,Sigrid, AU - Staelens,Steven, Y1 - 2017/12/06/ PY - 2017/06/01/received PY - 2017/11/20/accepted PY - 2017/12/7/entrez PY - 2017/12/7/pubmed PY - 2017/12/30/medline SP - e0189155 EP - e0189155 JF - PloS one JO - PLoS ONE VL - 12 IS - 12 N2 - BACKGROUND: Increased brain uptake on [18F]AV45 PET is a biomarker for Alzheimer's disease (AD). The standardised uptake value ratio (SUVR) is widely used for quantification but is subject to variability. Here we evaluate how SUVR of a cortical target region is affected by blood flow changes in the target and two frequently used reference regions. METHODS: Regional baseline time-activity curves (TACs) were simulated based on metabolite-corrected plasma input functions and pharmacokinetic parameters obtained from our previously acquired data in healthy control (HC; n = 10), amnestic mild cognitive impairment (aMCI; n = 15) and AD cohorts (n = 9). Blood flow changes were simulated by altering the regional tracer delivery rate K1 (and clearance rate k2) between -40% and +40% from its regional baseline value in the target region and/or cerebellar grey (CB) or subcortical white matter (WM) reference regions. The corresponding change in SUVR was calculated at 50-60 min post-injection. RESULTS: A -40% blood flow reduction in the target resulted in an increased SUVRtarget (e.g. SUVRprecuneus: +10.0±5% in HC, +2.5±2% in AD), irrespective of the used reference region. A -40% blood flow reduction in the WM reference region increased SUVRWM (+11.5±4% in HC, +13.5±3% in AD) while a blood flow reduction in CB decreased SUVRCB (-9.5±6% in HC, -5.5±2% in AD), irrespective of the used target region. A -40% flow reduction in both the precuneus and reference WM (i.e., global flow change) induced an increased SUVR (+22.5±8% in HC, +16.0±4% in AD). When considering reference CB instead, SUVR was decreased by less than -5% (both in HC and AD). CONCLUSION: Blood flow changes introduce alterations in [18F]AV45 PET SUVR. Flow reductions in the CB and WM reference regions resulted in a decreased and increased SUVR of the target, respectively. SUVR was more affected by global blood flow changes when considering WM instead of CB normalization. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/29211812/A_simulation_study_on_the_impact_of_the_blood_flow_dependent_component_in_[18F]AV45_SUVR_in_Alzheimer's_disease_ L2 - http://dx.plos.org/10.1371/journal.pone.0189155 DB - PRIME DP - Unbound Medicine ER -