Usefulness of Dual-Point Amyloid PET Scans in Appropriate Use Criteria: A Multicenter Study

J Alzheimers Dis. 2018;65(3):765-779. doi: 10.3233/JAD-180232.

Abstract

Background: Biomarkers of neurodegeneration play a major role in the diagnosis of Alzheimer's disease (AD). Information on both amyloid-β accumulation, e.g., from amyloid positron emission tomography (PET), and downstream neuronal injury, e.g., from 18F-fluorodeoxyglucose (FDG) PET, would ideally be obtained in a single procedure.

Objective: On the basis that the parallelism between brain perfusion and glucose metabolism is well documented, the objective of this work is to evaluate whether brain perfusion estimated in a dual-point protocol of 18F-florbetaben (FBB) PET can be a surrogate of FDG PET in appropriate use criteria (AUC) for amyloid PET.

Methods: This study included 47 patients fulfilling international AUC for amyloid PET. FDG PET, early FBB (pFBB) PET (0-10 min post injection), and standard FBB (sFBB) PET (90-110 min post injection) scans were acquired. Results of clinical subjective reports and of quantitative region of interest (ROI)-based analyses were compared between procedures using statistical techniques such as Pearson's correlation coefficients and t-tests.

Results: pFBB and FDG visual reports on the 47 patients showed good agreement (k > 0.74); ROI quantitative analysis indicated that both data modalities are highly correlated; and the t-test analysis does not reject the null hypothesis that data from pFBB and FDG examinations comes from independent random samples from normal distributions with equal means and variances.

Conclusions: A good agreement was found between pFBB and FDG data as obtained by subjective visual and quantitative analyses. Dual-point FBB PET scans could offer complementary information (similar to that from FDG PET and FBB PET) in a single procedure, considering pFBB as a surrogate of FDG.

Keywords: Alzheimer’s disease; FDG PET; amyloid PET; appropriate use criteria; brain perfusion; brain rCBF; brain rCMRglc; florbetaben PET; mild cognitive impairment; quantitative analysis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amyloid / metabolism*
  • Aniline Compounds
  • Brain / diagnostic imaging*
  • Brain / metabolism*
  • Cognitive Dysfunction / diagnostic imaging
  • Cognitive Dysfunction / metabolism
  • Dementia / diagnostic imaging
  • Dementia / metabolism
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Humans
  • Mental Disorders / diagnostic imaging
  • Mental Disorders / metabolism
  • Positron-Emission Tomography / methods*
  • Prospective Studies
  • Radiopharmaceuticals
  • Stilbenes

Substances

  • Amyloid
  • Aniline Compounds
  • Radiopharmaceuticals
  • Stilbenes
  • Fluorodeoxyglucose F18
  • 4-(N-methylamino)-4'-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy)stilbene