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Dual-phase [18F]florbetapir in frontotemporal dementia.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Asghar, Michael 
Hinz, Rainer 
Herholz, Karl 

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.

Description

Keywords

Dual-biomarker, FDG, Florbetapir, PET, bvFTD, Aniline Compounds, Ethylene Glycols, Female, Fluorodeoxyglucose F18, Frontotemporal Dementia, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Positron-Emission Tomography

Journal Title

Eur J Nucl Med Mol Imaging

Conference Name

Journal ISSN

1619-7070
1619-7089

Volume Title

46

Publisher

Springer Science and Business Media LLC