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

Article type: Research Article

Authors: Segovia, Fermín^{a; b; *} | Gómez-Río, Manuel^{c; d} | Sánchez-Vañó, Raquel^{e; f} | Górriz, Juan Manuel^{a; b; d} | Ramírez, Javier^{a; b; d} | Triviño-Ibáñez, Eva^{c; d} | Carnero-Pardo, Cristóbal^{d; g} | Martínez-Lozano, María Dolores^h | Sopena-Novales, Pablo^e

Affiliations: [a] Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain | [b] DASCI Institute, University of Granada, Granada, Spain | [c] Department of Nuclear Medicine, “Virgen de las Nieves” University Hospital, Granada, Spain | [d] Biosanitary Investigation Institute of Granada, Granada, Spain | [e] Department of Nuclear Medicine, “9 de Octubre” Hospital, Valencia, Spain | [f] Clinical Medicine and Public Health Doctoral Program of the University of Granada, Granada, Spain | [g] Department of Neurology, “Virgen de las Nieves” University Hospital, Granada, Spain | [h] Department of Neurology, “La Magdalena” Hospital, Castellón, Spain

Correspondence: [*] Correspondence to: Fermín Segovia, Calle Periodista Rafael Gómez Montero, 2, E-18071 Granada, Spain. Tel.: +34958241717; E-mail: fsegovia@ugr.es.

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, amyloid PET, appropriate use criteria, brain perfusion, brain rCBF, brain rCMRglc, FDG PET, florbetaben PET, mild cognitive impairment, quantitative analysis

DOI: 10.3233/JAD-180232

Journal: Journal of Alzheimer's Disease, vol. 65, no. 3, pp. 765-779, 2018