Early-Phase 18F-Florbetaben PET as an Alternative Modality for 18F-FDG PET

Abstract

Purpose Based on the possibility that early-phase florbetaben (E-FBB) brain PET can be a surrogate for brain perfusion imaging, we conducted this study to investigate the clinical utility of E-FBB PET instead of 18F-FDG brain PET. Materials and Methods This prospective study included 35 patients with clinical suspicion of cognitive decline or dementia and 5 healthy controls. Brain MRI, E-FBB PET, late-phase FBB PET, and FDG PET were acquired. The regional SUV ratios (SUVRs) were calculated by cortical surface region of interest analysis using individual MRI, and relationship between E-FBB and FDG PET was analyzed. All PET scans were scored and analyzed as per visual scoring system, which represent tracer uptake abnormality. Moreover, uptake patterns were analyzed to determine the disease. Results Among the 40 subjects, 19 were amyloid-positive and 21 were amyloid-negative on late-phase FBB PET. Cortical surface region of interest analysis conducted for comparing between E-FBB and FDG PET revealed significant correlations (P < 0.0001) for regional SUVR among all brain regions; however, the SUVR values of FDG PET were statistically higher than those of E-FBB PET. Similarly, although the visually rated scores for E-FBB and FDG PET showed significant correlation (P < 0.0001), it was considered that the tracer uptake was more severely decreased for FDG PET. The disease types, specified by E-FBB and FDG PET, were statistically correlated. Conclusions E-FBB PET could potentially be a useful biomarker for the diagnosis of dementia in place of FDG PET. Nevertheless, the severity of the disease was more accurately determined by FDG PET.

Early-phase 18F-FP-CIT and 18F-flutemetamol PET were significantly correlated

“…Most previous studies that reported the usefulness of early-phase 18 F-FP-CIT or amyloid PET performed validation with 18 F-FDG PET 15 , 19 – 23 or 15 O-water perfusion PET 24 , but our study did not. Patients included in our retrospective study did not undergo 18 F-FDG or perfusion PET imaging, so we cannot validate that early-phase PETs in our study reflect true brain perfusion.…”

“…In our study, 18 F-flutemetamol was used as a radiopharmaceutical for amyloid PET. Previous studies that reported the usefulness of early-phase imaging with amyloid PET have used 11 C-Pittsburgh Compound B 19 , 22 , 24 , 27 , 28 , 18 F-florbetapir 20 , 23 , or 18 F-florbetaben 15 , 18 , 28 , 29 , and we could find only single previous report using 18 F-flutemetamol 26 . Since this study was carried out retrospectively, we could not select the radiopharmaceuticals used for amyloid PET.…”

High Correlation of Static First-Minute-Frame (FMF) PET Imaging after 18F-Labeled Amyloid Tracer Injection with [18F]FDG PET Imaging

“…In this study, FMFs were acquired with the three approved and commercially available 18 F-labeled amyloid tracers, namely [ 18 F]FBP, [ 18 F]FBB, and [ 18 F]FMM [ 8 ]. Whereas early-phase amyloid PET images have been evaluated in various studies as a surrogate for cerebral metabolism using [ 18 F]FBP [ 22 , 23 , 24 , 25 , 26 , 27 ] and [ 18 F]FBB [ 19 , 28 , 29 , 30 , 31 ], no study comparing early-phase amyloid PET acquisitions with [ 18 F]FMM to [ 18 F]FDG PET images was found during the writing of this manuscript. However, the optimal time windows for the acquisition of dual-phase [ 18 F]FMM PET images are being investigated [ 32 ] in addition to its perfusion information [ 33 ].…”

“…Moreover, a slight increase of correlation coefficients in Aβ+ patients compared to Aβ− patients can be observed in our study despite not showing statistically significant differences, similarly to the results of Daerr et al However, a statistically significant difference in the [ 18 F]FMM subcohort indicates higher correlation coefficients in the Aβ− group. Additionally, Son et al [ 31 ] obtained correlation coefficients reaching r = 0.8752 in the left temporal lobe, comparing static 5-min early [ 18 F]FBB PET images to [ 18 F]FDG PET. In our study, the [ 18 F]FBB FMF shows a correlation of r = 0.91 in the left temporal VOI to [ 18 F]FDG PET.…”

“…Early-phase brain amyloid PET images haven been shown to correlate positively with [ 18 F]FDG and [ 15 O]H 2 O brain PET images and offer perfusion information. The studies investigating early-phase brain amyloid PET images use mainly [ 11 C]PiB [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], [ 18 F]FBP [ 22 , 23 , 24 , 25 , 26 , 27 ], and [ 18 F]FBB [ 19 , 28 , 29 , 30 , 31 ]. In the case of [ 18 F]FMM, the dual-time protocol has been studied [ 32 ] and the perfusion information has previously been evaluated [ 33 ] but early-phase [ 18 F]FMM has not been compared to [ 18 F]FDG.…”