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Dual-phase [18F]florbetapir in frontotemporal dementia.
Eur J Nucl Med Mol Imaging 2019; 46(2):304-311EJ

Abstract

PURPOSE

The PET tracer [18F]florbetapir is a specific fibrillar amyloid-beta (Aβ) biomarker. During the late scan phase (> 40 min), it provides pathological information about Aβ status. Early scan phase (0-10 min) can provide FDG-'like' information. The current investigation tested the feasibility of using florbetapir as a dual-phase biomarker in behavioural variant frontotemporal dementia (bvFTD).

METHODS

Eight bvFTD patients underwent [18F]florbetapir and [18]FDG-PET scans. Additionally, ten healthy controls and ten AD patients underwent florbetapir-PET only. PET data were acquired dynamically for 60-min post-injection. The bvFTD PET data were used to define an optimal time window, representing blood flow-related pseudo-metabolism ('pseudo-FDG'), of florbetapir data that maximally correlated with the corresponding real FDG SUVR (40-60 min) in a composite neocortical FTD region.

RESULTS

A 2 to 5-min time window post-injection of the florbetapir-PET data provided the largest correlation (Pearson's r = 0.79, p = 0.02) to the FDG data. The pseudo-FDG images demonstrated strong internal consistency with actual FDG data and were also visually consistent with the bvFTD patients' hypometabolic profiles. The ability to identify bvFTD from blind visual rating of pseudo-FDG images was consistent with previous reports using FDG data (sensitivity = 75%, specificity = 85%).

CONCLUSIONS

This investigation demonstrates that early phase florbetapir uptake shows a reduction of frontal lobe perfusion in bvFTD, similar to metabolic findings with FDG. Thus, dynamic florbetapir scans can serve as a dual-phase biomarker in dementia patients to distinguish FTD from AD and cognitively normal elderly, removing the need for a separate FDG-PET scan in challenging dementia cases.

Authors+Show Affiliations

Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK. Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK.Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK.Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK.Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK. stephen.f.carter@manchester.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30569187

Citation

Asghar, Michael, et al. "Dual-phase [18F]florbetapir in Frontotemporal Dementia." European Journal of Nuclear Medicine and Molecular Imaging, vol. 46, no. 2, 2019, pp. 304-311.
Asghar M, Hinz R, Herholz K, et al. Dual-phase [18F]florbetapir in frontotemporal dementia. Eur J Nucl Med Mol Imaging. 2019;46(2):304-311.
Asghar, M., Hinz, R., Herholz, K., & Carter, S. F. (2019). Dual-phase [18F]florbetapir in frontotemporal dementia. European Journal of Nuclear Medicine and Molecular Imaging, 46(2), pp. 304-311. doi:10.1007/s00259-018-4238-2.
Asghar M, et al. Dual-phase [18F]florbetapir in Frontotemporal Dementia. Eur J Nucl Med Mol Imaging. 2019;46(2):304-311. PubMed PMID: 30569187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dual-phase [18F]florbetapir in frontotemporal dementia. AU - Asghar,Michael, AU - Hinz,Rainer, AU - Herholz,Karl, AU - Carter,Stephen F, Y1 - 2018/12/19/ PY - 2018/09/05/received PY - 2018/12/05/accepted PY - 2018/12/21/pubmed PY - 2019/5/8/medline PY - 2018/12/21/entrez KW - Dual-biomarker KW - FDG KW - Florbetapir KW - PET KW - bvFTD SP - 304 EP - 311 JF - European journal of nuclear medicine and molecular imaging JO - Eur. J. Nucl. Med. Mol. Imaging VL - 46 IS - 2 N2 - PURPOSE: The PET tracer [18F]florbetapir is a specific fibrillar amyloid-beta (Aβ) biomarker. During the late scan phase (> 40 min), it provides pathological information about Aβ status. Early scan phase (0-10 min) can provide FDG-'like' information. The current investigation tested the feasibility of using florbetapir as a dual-phase biomarker in behavioural variant frontotemporal dementia (bvFTD). METHODS: Eight bvFTD patients underwent [18F]florbetapir and [18]FDG-PET scans. Additionally, ten healthy controls and ten AD patients underwent florbetapir-PET only. PET data were acquired dynamically for 60-min post-injection. The bvFTD PET data were used to define an optimal time window, representing blood flow-related pseudo-metabolism ('pseudo-FDG'), of florbetapir data that maximally correlated with the corresponding real FDG SUVR (40-60 min) in a composite neocortical FTD region. RESULTS: A 2 to 5-min time window post-injection of the florbetapir-PET data provided the largest correlation (Pearson's r = 0.79, p = 0.02) to the FDG data. The pseudo-FDG images demonstrated strong internal consistency with actual FDG data and were also visually consistent with the bvFTD patients' hypometabolic profiles. The ability to identify bvFTD from blind visual rating of pseudo-FDG images was consistent with previous reports using FDG data (sensitivity = 75%, specificity = 85%). CONCLUSIONS: This investigation demonstrates that early phase florbetapir uptake shows a reduction of frontal lobe perfusion in bvFTD, similar to metabolic findings with FDG. Thus, dynamic florbetapir scans can serve as a dual-phase biomarker in dementia patients to distinguish FTD from AD and cognitively normal elderly, removing the need for a separate FDG-PET scan in challenging dementia cases. SN - 1619-7089 UR - https://www.unboundmedicine.com/medline/citation/30569187/Dual_phase_[18F]florbetapir_in_frontotemporal_dementia_ L2 - https://dx.doi.org/10.1007/s00259-018-4238-2 DB - PRIME DP - Unbound Medicine ER -