Pharmacokinetic modelling for the simultaneous assessment of perfusion and 18F-flutemetamol uptake in cerebral amyloid angiopathy using a reduced PET-MR acquisition time: Proof of concept

NeuroImage

Gerard Thompson¹  Mark A. Rodrigues²  Christophe Lucatelli³  Chengjia Wang⁴  Joanna M. Wardlaw⁴  Giorgos Papanastasiou⁵  Rustam Al-Shahi Salman⁵  Edwin J.R. van Beek⁵  Kerstin Heurling⁵ 

[1] Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK;Corresponding author.;Antaros Medical, Mölndal, Sweden;Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK;Edinburgh Imaging Facility, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK;

关键词: Positron emission tomography;    Magnetic resonance imaging;    Pharmacokinetic modelling;    Perfusion;    18F-flutemetamol uptake;    Cerebral amyloid angiopathy;   

DOI  :  

来源: DOAJ

【 摘 要 】

Purpose: Cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease associated with perivascular β-amyloid deposition. CAA is also associated with strokes due to lobar intracerebral haemorrhage (ICH). 18F-flutemetamol amyloid ligand PET may improve the early detection of CAA. We performed pharmacokinetic modelling using both full (0–30, 90–120 min) and reduced (30 min) 18F-flutemetamol PET-MR acquisitions, to investigate regional cerebral perfusion and amyloid deposition in ICH patients. Methods: Dynamic18F-flutemetamol PET-MR was performed in a pilot cohort of sixteen ICH participants; eight lobar ICH cases with probable CAA and eight deep ICH patients. A model-based input function (mIF) method was developed for compartmental modelling. mIF 1-tissue (1-TC) and 2-tissue (2-TC) compartmental modelling, reference tissue models and standardized uptake value ratios were assessed in the setting of probable CAA detection. Results: The mIF 1-TC model detected perfusion deficits and 18F-flutemetamol uptake in cases with probable CAA versus deep ICH patients, in both full and reduced PET acquisition time (all P < 0.05). In the reduced PET acquisition, mIF 1-TC modelling reached the highest sensitivity and specificity in detecting perfusion deficits (0.87, 0.77) and 18F-flutemetamol uptake (0.83, 0.71) in cases with probable CAA. Overall, 52 and 48 out of the 64 brain areas with 18F-flutemetamol-determined amyloid deposition showed reduced perfusion for 1-TC and 2-TC models, respectively. Conclusion: Pharmacokinetic (1-TC) modelling using a 30 min PET-MR time frame detected impaired haemodynamics and increased amyloid load in probable CAA. Perfusion deficits and amyloid burden co-existed within cases with CAA, demonstrating a distinct imaging pattern which may have merit in elucidating the pathophysiological process of CAA.

【 授权许可】

Unknown