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Eur J Nucl Med Mol Imaging. 2016 Jul;43(7):1304-14. doi: 10.1007/s00259-016-3359-8. Epub 2016 Mar 22.

Imaging characteristic of dual-phase (18)F-florbetapir (AV-45/Amyvid) PET for the concomitant detection of perfusion deficits and beta-amyloid deposition in Alzheimer's disease and mild cognitive impairment.

Author information

1
Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital and University, 5. Fu-Hsing Street, Kuei Shan Hsiang, Taoyuan, Taiwan. lin4857@adm.cgmh.org.tw.
2
Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. lin4857@adm.cgmh.org.tw.
3
Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital and University, 5. Fu-Hsing Street, Kuei Shan Hsiang, Taoyuan, Taiwan.
4
Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
5
Section of Dementia and Cognitive Impairment, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
6
Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.
7
Department of Neurology, Linkou Chang Gung Memorial Hospital and University, Taoyuan, Taiwan.

Abstract

PURPOSE:

We investigated dual-phase (18)F-florbetapir (AV-45/Amyvid) PET imaging for the concomitant detection of brain perfusion deficits and beta-amyloid deposition in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (MCI), and in cognitively healthy controls (HCs).

METHODS:

A total of 82 subjects (24 AD patients, 44 MCI patients and 14 HCs) underwent both dual-phase (18)F-AV-45 PET and MRI imaging. Dual-phase dynamic PET imaging consisted of (1) five 1-min scans obtained 1 - 6 min after tracer injection (perfusion (18)F-AV-45 imaging, pAV-45), and (2) ten 1-min scans obtained 50 - 60 min after tracer injection (amyloid (18)F-AV-45 imaging). Amyloid-negative MCI/AD patients were excluded. Volume of interest analysis and statistical parametric mapping of pAV-45 and (18)F-AV-45 images were performed to investigate the perfusion deficits and the beta-amyloid burden in the three study groups. The associations between Mini-Mental State Examination (MMSE) scores and global perfusion deficits and amyloid deposition were investigated with linear and segmental linear correlation analyses.

RESULTS:

HCs generally had normal pAV-45 findings, whereas perfusion deficits were evident in the hippocampus, and temporal, parietal and middle frontal cortices in both MCI and AD patients. The motor-sensory cortex was relatively preserved. MMSE scores in the entire study cohort were significantly associated with the degree of perfusion impairment as assessed by pAV-45 imaging (r = 0.5156, P < 0.0001). (18)F-AV-45 uptake was significantly higher in AD patients than in the two other study groups. However, the correlation between MMSE scores and (18)F-AV-45 uptake in MCI patients was more of a binary phenomenon and began in MCI patients with MMSE score 23.14 when (18)F-AV-45 uptake was higher and MMSE score lower than in patients with early MCI. Amyloid deposition started in the precuneus and the frontal and temporal regions in early MCI, ultimately reaching the maximum burden in advanced MCI.

CONCLUSION:

Our results indicate that brain perfusion deficits and beta-amyloid deposition in AD follow different trajectories that can be successfully traced using dual-phase (18)F-AV-45 PET imaging.

KEYWORDS:

18F-Florbetapir (AV-45/Amyvid); Alzheimer’s disease; Amyloid; Dementia; Dual-phase scan; Mild cognitive impairment; Perfusion deficits

PMID:
27003417
DOI:
10.1007/s00259-016-3359-8
[Indexed for MEDLINE]

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