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Yang Y, Li X, Lu J, Ge J, Chen M, Yao R, Tian M, Wang J, Liu F, Zuo C. Recent progress in the applications of presynaptic dopaminergic positron emission tomography imaging in parkinsonism. Neural Regen Res 2025; 20:93-106. [PMID: 38767479 PMCID: PMC11246150 DOI: 10.4103/1673-5374.391180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/18/2023] [Indexed: 05/22/2024] Open
Abstract
Nowadays, presynaptic dopaminergic positron emission tomography, which assesses deficiencies in dopamine synthesis, storage, and transport, is widely utilized for early diagnosis and differential diagnosis of parkinsonism. This review provides a comprehensive summary of the latest developments in the application of presynaptic dopaminergic positron emission tomography imaging in disorders that manifest parkinsonism. We conducted a thorough literature search using reputable databases such as PubMed and Web of Science. Selection criteria involved identifying peer-reviewed articles published within the last 5 years, with emphasis on their relevance to clinical applications. The findings from these studies highlight that presynaptic dopaminergic positron emission tomography has demonstrated potential not only in diagnosing and differentiating various Parkinsonian conditions but also in assessing disease severity and predicting prognosis. Moreover, when employed in conjunction with other imaging modalities and advanced analytical methods, presynaptic dopaminergic positron emission tomography has been validated as a reliable in vivo biomarker. This validation extends to screening and exploring potential neuropathological mechanisms associated with dopaminergic depletion. In summary, the insights gained from interpreting these studies are crucial for enhancing the effectiveness of preclinical investigations and clinical trials, ultimately advancing toward the goals of neuroregeneration in parkinsonian disorders.
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Affiliation(s)
- Yujie Yang
- Key Laboratory of Arrhythmias, Ministry of Education, Department of Medical Genetics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, and State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinyi Li
- Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, and State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiaying Lu
- Department of Nuclear Medicine & PET Center, National Center for Neurological Disorders, and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- Department of Nuclear Medicine & PET Center, National Center for Neurological Disorders, and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Mingjia Chen
- Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, and State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ruixin Yao
- Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, and State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Mei Tian
- Department of Nuclear Medicine & PET Center, National Center for Neurological Disorders, and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- International Human Phenome Institutes (Shanghai), Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Jian Wang
- Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, and State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Fengtao Liu
- Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, and State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuantao Zuo
- Department of Nuclear Medicine & PET Center, National Center for Neurological Disorders, and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
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Zhang Q, Li F, Wei M, Wang M, Wang L, Han Y, Jiang J. Prediction of Cognitive Progression Due to Alzheimer's Disease in Normal Participants Based on Individual Default Mode Network Metabolic Connectivity Strength. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:660-667. [PMID: 38631552 DOI: 10.1016/j.bpsc.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/11/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Predicting cognitive decline among individuals in the aging population who are already amyloid-β (Aβ) positive or tau positive poses clinical challenges. In Alzheimer's disease research, intra-default mode network (DMN) connections play a pivotal role in diagnosis. In this article, we propose metabolic connectivity within the DMN as a supplementary biomarker to the Aβ, pathological tau, and neurodegeneration framework. METHODS Extracting data from 1292 participants in the Alzheimer's Disease Neuroimaging Initiative, we collected paired T1-weighted structural magnetic resonance imaging and 18F-labeled-fluorodeoxyglucose positron emission computed tomography scans. Individual metabolic DMN networks were constructed, and metabolic connectivity (MC) strength in the DMN was assessed. In the cognitively unimpaired group, the Cox model identified cognitively unimpaired (MC+), high-risk participants, with Kaplan-Meier survival analyses and hazard ratios revealing the strength of MC's predictive performance. Spearman correlation analyses explored relationships between MC strength, and Aβ, pathological tau, neurodegeneration biomarkers, and clinical scales. DMN standard uptake value ratio (SUVR) provided comparative insights in the analyses. RESULTS Both MC strength and SUVR exhibited gradual declines with cognitive deterioration, displaying significant intergroup differences. Survival analyses indicated enhanced Aβ and tau prediction with both metrics, with MC strength outperforming SUVR. Combined MC strength and Aβ yielded optimal predictive performance (hazard ratio = 9.29), followed by MC strength and tau (hazard ratio = 8.92). Generally, the strength of MC's correlations with Aβ, pathological tau, and neurodegeneration biomarkers exceeded SUVR. CONCLUSIONS Individuals with normal cognition and disrupted DMN metabolic connectivity face an elevated risk of cognitive decline linked to Aβ that precedes metabolic issues.
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Affiliation(s)
- Qi Zhang
- School of Communication & Information Engineering, Shanghai University, Shanghai, China; School of Life Sciences, Shanghai University, Shanghai, China
| | - Fangjie Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Wei
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Min Wang
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Luyao Wang
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China; School of Biomedical Engineering, Hainan University, Haikou, China; Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China; National Clinical Research Center for Geriatric Diseases, Beijing, China.
| | - Jiehui Jiang
- School of Life Sciences, Shanghai University, Shanghai, China.
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Wang M, Lu J, Zhang Y, Zhang Q, Wang L, Wu P, Brendel M, Rominger A, Shi K, Zhao Q, Jiang J, Zuo C. Characterization of tau propagation pattern and cascading hypometabolism from functional connectivity in Alzheimer's disease. Hum Brain Mapp 2024; 45:e26689. [PMID: 38703095 PMCID: PMC11069321 DOI: 10.1002/hbm.26689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/16/2024] [Accepted: 04/08/2024] [Indexed: 05/06/2024] Open
Abstract
Tau pathology and its spatial propagation in Alzheimer's disease (AD) play crucial roles in the neurodegenerative cascade leading to dementia. However, the underlying mechanisms linking tau spreading to glucose metabolism remain elusive. To address this, we aimed to examine the association between pathologic tau aggregation, functional connectivity, and cascading glucose metabolism and further explore the underlying interplay mechanisms. In this prospective cohort study, we enrolled 79 participants with 18F-Florzolotau positron emission tomography (PET), 18F-fluorodeoxyglucose PET, resting-state functional, and anatomical magnetic resonance imaging (MRI) images in the hospital-based Shanghai Memory Study. We employed generalized linear regression and correlation analyses to assess the associations between Florzolotau accumulation, functional connectivity, and glucose metabolism in whole-brain and network-specific manners. Causal mediation analysis was used to evaluate whether functional connectivity mediates the association between pathologic tau and cascading glucose metabolism. We examined 22 normal controls and 57 patients with AD. In the AD group, functional connectivity was associated with Florzolotau covariance (β = .837, r = 0.472, p < .001) and glucose covariance (β = 1.01, r = 0.499, p < .001). Brain regions with higher tau accumulation tend to be connected to other regions with high tau accumulation through functional connectivity or metabolic connectivity. Mediation analyses further suggest that functional connectivity partially modulates the influence of tau accumulation on downstream glucose metabolism (mediation proportion: 49.9%). Pathologic tau may affect functionally connected neurons directly, triggering downstream glucose metabolism changes. This study sheds light on the intricate relationship between tau pathology, functional connectivity, and downstream glucose metabolism, providing critical insights into AD pathophysiology and potential therapeutic targets.
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Affiliation(s)
- Min Wang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Jiaying Lu
- Department of Nuclear Medicine & PET Center, Huashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
| | - Ying Zhang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Qi Zhang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Luyao Wang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Ping Wu
- Department of Nuclear Medicine & PET Center, Huashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
| | | | - Axel Rominger
- Department of Nuclear Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
- Computer Aided Medical Procedures, School of Computation, Information and TechnologyTechnical University of MunichMunichGermany
| | - Qianhua Zhao
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
- Department of Neurology, Huashan HospitalFudan UniversityShanghaiChina
| | - Jiehui Jiang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Chuantao Zuo
- Department of Nuclear Medicine & PET Center, Huashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
- Human Phenome InstituteFudan UniversityShanghaiChina
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Zhang Q, Fan C, Wang L, Li T, Wang M, Han Y, Jiang J. Glucose metabolism in posterior cingulate cortex has supplementary value to predict the progression of cognitively unimpaired to dementia due to Alzheimer's disease: an exploratory study of 18F-FDG-PET. GeroScience 2024; 46:1407-1420. [PMID: 37610594 PMCID: PMC10828178 DOI: 10.1007/s11357-023-00897-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023] Open
Abstract
Amyloid-β (Aβ) and tau are important biomarkers to predict the progression of cognitively unimpaired (CU) to dementia due to Alzheimer's disease (AD), according to the diagnosis framework from the US National Institute on Aging and the Alzheimer's Association (NIA-AA). However, it is clinically difficult to predict those subjects who were already with Aβ positive (A +) or tau positive (T +). As a typical characteristic of neurodegeneration in the diagnosis framework, the hypometabolism of the posterior cingulate cortex (PCC) has significant clinical value in the early prediction and prevention of AD. In this paper, we proposed the glucose metabolism in the PCC as a biomarker supplement to Aβ and tau biomarkers. First, we calculated the standard uptake value ratio (SUVR) of PCC based on fluorodeoxyglucose positron emission computed tomography (FDG PET) imaging. Secondly, we performed Kaplan-Meier (KM) survival analyses to explore the predictive performance of PCC SUVR, and the hazard ratio (HR) was calculated. Finally, we performed Pearson correlation analyses to explore the physiological significance of PCC SUVR. As a result, the PCC SUVR showed a consistent downward trend along the AD continuum. KM analyses showed better predictive performance when we combined PCC SUVR with cerebro-spinal fluid (CSF) Aβ42 (from HR = 2.56 to 3.00 within 5 years; from HR = 2.76 to 4.20 within 10 years) and ptau-181 (from 2.83 to 3.91 within 5 years; from HR = 2.32 to 4.17 within 10 years). There was a slight correlation between Aβ42/Aβ40 and PCC SUVR (r = 0.14, p = 0.02). In addition, several cognition scales were also correlated to PCC SUVR (from r = -0.407 to 0.383, p < 0.05). Our results showed that glucose metabolism in PCC may be a potential biomarker supplement to the Aβ and tau biomarkers to predict the progression of CU to AD.
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Affiliation(s)
- Qi Zhang
- School of Communication & Information Engineering, Shanghai University, Shanghai, 200444, China
| | - Chunqiu Fan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Luyao Wang
- School of Life Science, Shanghai University, Shanghai, 200444, China
| | - Taoran Li
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu, 210029, China
| | - Min Wang
- School of Life Science, Shanghai University, Shanghai, 200444, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
- School of Biomedical Engineering, Hainan University, Haikou, 570228, China.
- Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, 100053, China.
- National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
| | - Jiehui Jiang
- School of Life Science, Shanghai University, Shanghai, 200444, China.
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Sichuan, 646000, China.
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Wang J, Xue L, Jiang J, Liu F, Wu P, Lu J, Zhang H, Bao W, Xu Q, Ju Z, Chen L, Jiao F, Lin H, Ge J, Zuo C, Tian M. Diagnostic performance of artificial intelligence-assisted PET imaging for Parkinson's disease: a systematic review and meta-analysis. NPJ Digit Med 2024; 7:17. [PMID: 38253738 PMCID: PMC10803804 DOI: 10.1038/s41746-024-01012-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Artificial intelligence (AI)-assisted PET imaging is emerging as a promising tool for the diagnosis of Parkinson's disease (PD). We aim to systematically review the diagnostic accuracy of AI-assisted PET in detecting PD. The Ovid MEDLINE, Ovid Embase, Web of Science, and IEEE Xplore databases were systematically searched for related studies that developed an AI algorithm in PET imaging for diagnostic performance from PD and were published by August 17, 2023. Binary diagnostic accuracy data were extracted for meta-analysis to derive outcomes of interest: area under the curve (AUC). 23 eligible studies provided sufficient data to construct contingency tables that allowed the calculation of diagnostic accuracy. Specifically, 11 studies were identified that distinguished PD from normal control, with a pooled AUC of 0.96 (95% CI: 0.94-0.97) for presynaptic dopamine (DA) and 0.90 (95% CI: 0.87-0.93) for glucose metabolism (18F-FDG). 13 studies were identified that distinguished PD from the atypical parkinsonism (AP), with a pooled AUC of 0.93 (95% CI: 0.91 - 0.95) for presynaptic DA, 0.79 (95% CI: 0.75-0.82) for postsynaptic DA, and 0.97 (95% CI: 0.96-0.99) for 18F-FDG. Acceptable diagnostic performance of PD with AI algorithms-assisted PET imaging was highlighted across the subgroups. More rigorous reporting standards that take into account the unique challenges of AI research could improve future studies.
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Affiliation(s)
- Jing Wang
- Huashan Hospital & Human Phenome Institute, Fudan University, Shanghai, China
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Le Xue
- Department of Nuclear Medicine, the Second Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiehui Jiang
- Institute of Biomedical Engineering, School of Life Science, Shanghai University, Shanghai, China
| | - Fengtao Liu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, & National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Wu
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiaying Lu
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Huiwei Zhang
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiqi Bao
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Qian Xu
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Zizhao Ju
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Chen
- Department of Ultrasound Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Fangyang Jiao
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Huamei Lin
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China.
| | - Chuantao Zuo
- Huashan Hospital & Human Phenome Institute, Fudan University, Shanghai, China.
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, & National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
| | - Mei Tian
- Huashan Hospital & Human Phenome Institute, Fudan University, Shanghai, China.
- Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China.
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Tian M, Zuo C, Cahid Civelek A, Carrio I, Watanabe Y, Kang KW, Murakami K, Prior JO, Zhong Y, Dou X, Yu C, Jin C, Zhou R, Liu F, Li X, Lu J, Zhang H, Wang J. International consensus on clinical use of presynaptic dopaminergic positron emission tomography imaging in parkinsonism. Eur J Nucl Med Mol Imaging 2024; 51:434-442. [PMID: 37789188 DOI: 10.1007/s00259-023-06403-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Presynaptic dopaminergic positron emission tomography (PET) imaging serves as an essential tool in diagnosing and differentiating patients with suspected parkinsonism, including idiopathic Parkinson's disease (PD) and other neurodegenerative and non-neurodegenerative diseases. The PET tracers most commonly used at the present time mainly target dopamine transporters (DAT), aromatic amino acid decarboxylase (AADC), and vesicular monoamine type 2 (VMAT2). However, established standards for the imaging procedure and interpretation of presynaptic dopaminergic PET imaging are still lacking. The goal of this international consensus is to help nuclear medicine practitioners procedurally perform presynaptic dopaminergic PET imaging. METHOD A multidisciplinary task group formed by experts from various countries discussed and approved the consensus for presynaptic dopaminergic PET imaging in parkinsonism, focusing on standardized recommendations, procedures, interpretation, and reporting. CONCLUSION This international consensus and practice guideline will help to promote the standardized use of presynaptic dopaminergic PET imaging in parkinsonism. It will become an international standard for this purpose in clinical practice.
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Affiliation(s)
- Mei Tian
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China.
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Human Phenome Institute, Fudan University, Shanghai, 201203, China.
| | - Chuantao Zuo
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China.
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
| | - A Cahid Civelek
- Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins Medicine, Baltimore, MD, 21287, USA.
| | - Ignasi Carrio
- Research Institute and Department of Nuclear Medicine, Hospital Sant Pau, Autonomous University of Barcelona, 08025, Barcelona, Spain
| | - Yasuyoshi Watanabe
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, 650-0047, Japan
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Koji Murakami
- Department of Radiology, Juntendo University Hospital, Tokyo, 113-8431, Japan
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Yan Zhong
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Xiaofeng Dou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Congcong Yu
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Chentao Jin
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Rui Zhou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Fengtao Liu
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Xinyi Li
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Jiaying Lu
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, China.
- The College of Biomedical Engineering and Instrument Science of Zhejiang University, Hangzhou, 310007, China.
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310007, China.
| | - Jian Wang
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China.
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7
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Lu J, Clement C, Hong J, Wang M, Li X, Cavinato L, Yen TC, Jiao F, Wu P, Wu J, Ge J, Sun Y, Brendel M, Lopes L, Rominger A, Wang J, Liu F, Zuo C, Guan Y, Zhao Q, Shi K. Improved interpretation of 18F-florzolotau PET in progressive supranuclear palsy using a normalization-free deep-learning classifier. iScience 2023; 26:107426. [PMID: 37564702 PMCID: PMC10410511 DOI: 10.1016/j.isci.2023.107426] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/28/2023] [Accepted: 07/17/2023] [Indexed: 08/12/2023] Open
Abstract
While 18F-florzolotau tau PET is an emerging biomarker for progressive supranuclear palsy (PSP), its interpretation has been hindered by a lack of consensus on visual reading and potential biases in conventional semi-quantitative analysis. As clinical manifestations and regions of elevated 18F-florzolotau binding are highly overlapping in PSP and the Parkinsonian type of multiple system atrophy (MSA-P), developing a reliable discriminative classifier for 18F-florzolotau PET is urgently needed. Herein, we developed a normalization-free deep-learning (NFDL) model for 18F-florzolotau PET, which achieved significantly higher accuracy for both PSP and MSA-P compared to semi-quantitative classifiers. Regions driving the NFDL classifier's decision were consistent with disease-specific topographies. NFDL-guided radiomic features correlated with clinical severity of PSP. This suggests that the NFDL model has the potential for early and accurate differentiation of atypical parkinsonism and that it can be applied in various scenarios due to not requiring subjective interpretation, MR-dependent, and reference-based preprocessing.
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Affiliation(s)
- Jiaying Lu
- Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200235, China
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Christoph Clement
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Jimin Hong
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Min Wang
- Institute of Biomedical Engineering, School of Life Science, Shanghai University, Shanghai 200444, China
- Department of Informatics, Technical University of Munich, 80333 Munich, Germany
| | - Xinyi Li
- Department of Neurology & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200400, China
| | - Lara Cavinato
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- MOX - Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Tzu-Chen Yen
- APRINOIA Therapeutics Co., Ltd, Suzhou 215122, China
| | - Fangyang Jiao
- Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200235, China
| | - Ping Wu
- Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200235, China
| | - Jianjun Wu
- Department of Neurology & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200400, China
| | - Jingjie Ge
- Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200235, China
| | - Yimin Sun
- Department of Neurology & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200400, China
| | - Matthias Brendel
- Department of Nuclear Medicine, University of Munich, 80539 Munich, Germany
| | - Leonor Lopes
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Jian Wang
- Department of Neurology & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200400, China
| | - Fengtao Liu
- Department of Neurology & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200400, China
| | - Chuantao Zuo
- Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200235, China
- Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Yihui Guan
- Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200235, China
| | - Qianhua Zhao
- Department of Neurology & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200400, China
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Department of Informatics, Technical University of Munich, 80333 Munich, Germany
| | - for the Progressive Supranuclear Palsy Neuroimage Initiative (PSPNI)
- Department of Nuclear Medicine & PET Center & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200235, China
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Institute of Biomedical Engineering, School of Life Science, Shanghai University, Shanghai 200444, China
- Department of Informatics, Technical University of Munich, 80333 Munich, Germany
- Department of Neurology & National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200400, China
- MOX - Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
- APRINOIA Therapeutics Co., Ltd, Suzhou 215122, China
- Department of Nuclear Medicine, University of Munich, 80539 Munich, Germany
- Human Phenome Institute, Fudan University, Shanghai 200433, China
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Sun J, Jiang J, Ling R, Wang L, Jiang J, Wang M. Bidirectional Mapping Perception-enhanced Cycle-consistent Generative Adversarial Network for Super-resolution of Brain MRI images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38082859 DOI: 10.1109/embc40787.2023.10340042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
As an effective tool for visualizing neurodegeneration, high-resolution structural magnetism facilitates quantitative image analysis and clinical applications. Super-resolution reconstruction technology allows to improve the resolution of images without upgrading the scanning hardware. However, existing super-resolution techniques relied on paired image data sets and lacked further quantitative analysis of the generated images. In this study, we proposed a semi-supervised generative adversarial network (GAN) model for super-resolution of brain MRI, and the synthetic images were evaluated using various quantitative measures. This model adopted the cycle-consistency structure to allow for a mixture of unpaired data for training. Perceptual loss was further introduced into the model to preserve detailed texture features at high frequencies. 363 subjects with both high-resolution (HR) and low-resolution (LR) scans and 217 subjects with HR scans only were used for model derivation, training, and validation. We extracted multiple voxel-based and surface-based morphological features of the synthetic and real 3D HR images for comparison. We further evaluated the synthetic images in the differential diagnosis of diseases. Our model achieved superior mean absolute error (0.049±0.021), mean squared error (0.0059±0.0043), peak signal-to-noise ratio (29.41±3.71), structural similarity index measure (0.914±0.048). Eight morphological metrics, both voxel-based and surface-based, showed significant agreement (P<0.0001). The gap of accuracy in disease diagnosis between synthetic and real HR images was within 5% and significantly outperformed the LR images. Our proposed model enables the reconstruction of HR MRI and could be used accurately for image quantification.Clinical relevance- Quantitative evaluation of the synthetic high-resolution images was used to determine whether the synthetic images have sufficient realism and diversity.
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Zhang Q, Wang L, Han Y, Jiang J, Wang M. Brain Connectome Imaging Markers Research of Glucose Metabolism in the Early Stage of Alzheimer's Disease. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083740 DOI: 10.1109/embc40787.2023.10340657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
In recent years, increasing evidence had suggested that subjective cognitive decline (SCD) in unimpaired individuals may be the first symptom of Alzheimer's disease (AD). This study investigated the differences in the glucose metabolism network and the influence of the Apolipoprotein E (ApoE) gene between the SCD and normal control (NC) group by using graph theory. In this study, we included 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scans from Xuanwu Hospital in Beijing, China. 85 SCD subjects and 74 NC subjects were included. First, we calculated and compared network parameters between the two groups. We then identified the bilateral insula and bilateral parahippocampal gyrus as seed sites and studied the connections to the whole brain. The results showed that both the SCD and the NC showed small-world nature, but the metabolic network of SCD tended to be more regular. The clustering coefficient and local efficiency of SCD were significantly higher than those of NC (P<0.05). In addition, we found that carrying APOE resulted in enhanced metabolic connectivity, but with weaker aggregation and local information exchangeability. Our results suggested that there are differences in the glucose metabolic brain network between SCD and NC, suggesting that the graph-theoretic analysis method may provide evidence for the early pathological mechanism of AD.Clinical relevance- This study suggests that the graph-theoretic analysis method may provide evidence for the early pathological mechanism of AD.
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Lu J, Ma X, Zhang H, Xiao Z, Li M, Wu J, Ju Z, Chen L, Zheng L, Ge J, Liang X, Bao W, Wu P, Ding D, Yen TC, Guan Y, Zuo C, Zhao Q. Head-to-head comparison of plasma and PET imaging ATN markers in subjects with cognitive complaints. Transl Neurodegener 2023; 12:34. [PMID: 37381042 PMCID: PMC10308642 DOI: 10.1186/s40035-023-00365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 06/02/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Gaining more information about the reciprocal associations between different biomarkers within the ATN (Amyloid/Tau/Neurodegeneration) framework across the Alzheimer's disease (AD) spectrum is clinically relevant. We aimed to conduct a comprehensive head-to-head comparison of plasma and positron emission tomography (PET) ATN biomarkers in subjects with cognitive complaints. METHODS A hospital-based cohort of subjects with cognitive complaints with a concurrent blood draw and ATN PET imaging (18F-florbetapir for A, 18F-Florzolotau for T, and 18F-fluorodeoxyglucose [18F-FDG] for N) was enrolled (n = 137). The β-amyloid (Aβ) status (positive versus negative) and the severity of cognitive impairment served as the main outcome measures for assessing biomarker performances. RESULTS Plasma phosphorylated tau 181 (p-tau181) level was found to be associated with PET imaging of ATN biomarkers in the entire cohort. Plasma p-tau181 level and PET standardized uptake value ratios of AT biomarkers showed a similarly excellent diagnostic performance for distinguishing between Aβ+ and Aβ- subjects. An increased tau burden and glucose hypometabolism were significantly associated with the severity of cognitive impairment in Aβ+ subjects. Additionally, glucose hypometabolism - along with elevated plasma neurofilament light chain level - was related to more severe cognitive impairment in Aβ- subjects. CONCLUSION Plasma p-tau181, as well as 18F-florbetapir and 18F-Florzolotau PET imaging can be considered as interchangeable biomarkers in the assessment of Aβ status in symptomatic stages of AD. 18F-Florzolotau and 18F-FDG PET imaging could serve as biomarkers for the severity of cognitive impairment. Our findings have implications for establishing a roadmap to identifying the most suitable ATN biomarkers for clinical use.
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Affiliation(s)
- Jiaying Lu
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoxi Ma
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Huiwei Zhang
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ming Li
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Wu
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zizhao Ju
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Chen
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Zheng
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiqi Bao
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Wu
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | | | - Yihui Guan
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
| | - Chuantao Zuo
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
- Human Phenome Institute, Fudan University, Shanghai, China.
| | - Qianhua Zhao
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
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