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Diagnostic performance of regional cerebral blood flow images derived from dynamic PIB scans in Alzheimer's disease.

ABSTRACT: BACKGROUND:In clinical practice, visual assessment of glucose metabolism images is often used for the diagnosis of Alzheimer's disease (AD) through 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) scans. However, visual assessment of the characteristic AD hypometabolic pattern relies on the expertise of the reader. Therefore, user-independent pipelines are preferred to evaluate the images and to classify the subjects. Moreover, glucose consumption is highly correlated with cerebral perfusion. Regional cerebral blood flow (rCBF) images can be derived from dynamic 11C-labelled Pittsburgh Compound B PET scans, which are also used for the assessment of the deposition of amyloid-? plaques on the brain, a fundamental characteristic of AD. The aim of this study was to explore whether these rCBF PIB images could be used for diagnostic purposes through the PMOD Alzheimer's Discrimination Tool. RESULTS:Both tracer relative cerebral flow (R1) and early PIB (ePIB) (20-130?s) uptake presented a good correlation when compared to FDG standardized uptake value ratio (SUVR), while ePIB (1-8?min) showed a worse correlation. All receiver operating characteristic curves exhibited a similar shape, with high area under the curve values, and no statistically significant differences were found between curves. However, R1 and ePIB (1-8?min) had the highest sensitivity, while FDG SUVR had the highest specificity. CONCLUSION:rCBF images were suggested to be a good surrogate for FDG scans for diagnostic purposes considering an adjusted threshold value.

SUBMITTER: Peretti DE

PROVIDER: S-EPMC6609664 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Diagnostic performance of regional cerebral blood flow images derived from dynamic PIB scans in Alzheimer's disease.

Peretti Débora E DE Vállez García David D Reesink Fransje E FE Doorduin Janine J de Jong Bauke M BM De Deyn Peter P PP Dierckx Rudi A J O RAJO Boellaard Ronald R

EJNMMI research 20190704 1

<h4>Background</h4>In clinical practice, visual assessment of glucose metabolism images is often used for the diagnosis of Alzheimer's disease (AD) through 2-[<sup>18</sup>F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) scans. However, visual assessment of the characteristic AD hypometabolic pattern relies on the expertise of the reader. Therefore, user-independent pipelines are preferred to evaluate the images and to classify the subjects. Moreover, glucose consumption is h ...[more]

PMID: 31273465

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Project description:Intraindividual variability (IIV) across neuropsychological measures within a single testing session is a promising marker predictive of cognitive decline and development of Alzheimer's disease (AD). We have previously shown that greater IIV is cross-sectionally associated with reduced cerebral blood flow (CBF), but not with cortical thickness or brain volume, in older adults without dementia who were amyloid beta (Aβ) positive. However, there is little known about the association between change in IIV and CBF over time. Therefore, we examined 12-month longitudinal change in IIV and interactions of IIV and AD biomarker status on changes in regional CBF. Fifty-three non-demented Alzheimer's Disease Neuroimaging Initiative (ADNI) participants underwent lumbar puncture to obtain cerebrospinal fluid (CSF) at baseline and neuropsychological testing and magnetic resonance imaging (MRI) exams at baseline and 12-month follow-up evaluation. IIV was calculated as the intraindividual standard deviation across 6 demographically-corrected neuropsychological measures. Pulsed arterial spin labeling (ASL) MRI was acquired to quantify CBF and FreeSurfer-derived a priori CBF regions of interest (ROIs) were examined. AD biomarker positivity was determined using a published CSF p-tau/Aβ ratio cut-score. Change scores were calculated for IIV, CBF, and mean neuropsychological performance from baseline to 12 months. Hierarchical linear regression models showed that after adjusting for age and gender, there was a significant interaction between IIV change and biomarker-positivity (p-tau/Aβ+) for change in entorhinal and hippocampal CBF but not for the other ROIs. Specifically, increases in IIV were associated with reductions in entorhinal and hippocampal CBF among individuals who were biomarker-positive (n = 21). In contrast, there were no significant associations between change in IIV and CBF among those who were biomarker-negative (n = 32). Findings remained similar when analyses were performed adjusting for change in mean level of neuropsychological performance. Changes in IIV may be sensitive to changes in regional hypoperfusion in AD-vulnerable regions among AD biomarker-positive individuals, above and beyond demographics and mean neuropsychological performance. These findings provide further evidence supporting IIV as a potential marker of cerebrovascular brain changes in individuals at risk for dementia.

Dataset Information

Diagnostic performance of regional cerebral blood flow images derived from dynamic PIB scans in Alzheimer's disease.

Publications

Diagnostic performance of regional cerebral blood flow images derived from dynamic PIB scans in Alzheimer's disease.

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