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Burkett BJ, Johnson DR, Lowe VJ. Evaluation of Neurodegenerative Disorders with Amyloid-β, Tau, and Dopaminergic PET Imaging: Interpretation Pitfalls. J Nucl Med 2024; 65:829-837. [PMID: 38664015 DOI: 10.2967/jnumed.123.266463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/03/2024] [Indexed: 06/05/2024] Open
Abstract
Antiamyloid therapies for Alzheimer disease recently entered clinical practice, making imaging biomarkers for Alzheimer disease even more relevant to guiding patient management. Amyloid and tau PET are valuable tools that can provide objective evidence of Alzheimer pathophysiology in living patients and will increasingly be used to complement 18F-FDG PET in the diagnostic evaluation of cognitive impairment and dementia. Parkinsonian syndromes, also common causes of dementia, can likewise be evaluated with a PET imaging biomarker,18F-DOPA, allowing in vivo assessment of the presynaptic dopaminergic neurons. Understanding the role of these PET biomarkers will help the nuclear medicine physician contribute to the appropriate diagnosis and management of patients with cognitive impairment and dementia. To successfully evaluate brain PET examinations for neurodegenerative diseases, knowledge of the necessary protocol details for obtaining a reliable imaging study, inherent limitations for each PET radiopharmaceutical, and pitfalls in image interpretation is critical. This review will focus on underlying concepts for interpreting PET examinations, important procedural details, and guidance for avoiding potential interpretive pitfalls for amyloid, tau, and dopaminergic PET examinations.
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Affiliation(s)
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Kas A, Rozenblum L, Pyatigorskaya N. Clinical Value of Hybrid PET/MR Imaging: Brain Imaging Using PET/MR Imaging. Magn Reson Imaging Clin N Am 2023; 31:591-604. [PMID: 37741643 DOI: 10.1016/j.mric.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Hybrid PET/MR imaging offers a unique opportunity to acquire MR imaging and PET information during a single imaging session. PET/MR imaging has numerous advantages, including enhanced diagnostic accuracy, improved disease characterization, and better treatment planning and monitoring. It enables the immediate integration of anatomic, functional, and metabolic imaging information, allowing for personalized characterization and monitoring of neurologic diseases. This review presents recent advances in PET/MR imaging and highlights advantages in clinical practice for neuro-oncology, epilepsy, and neurodegenerative disorders. PET/MR imaging provides valuable information about brain tumor metabolism, perfusion, and anatomic features, aiding in accurate delineation, treatment response assessment, and prognostication.
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Affiliation(s)
- Aurélie Kas
- Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, APHP Sorbonne Université, Paris, France; Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris F-75006, France.
| | - Laura Rozenblum
- Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, APHP Sorbonne Université, Paris, France; Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris F-75006, France
| | - Nadya Pyatigorskaya
- Neuroradiology Department, Pitié-Salpêtrière Hospital, APHP Sorbonne Université, Paris, France; Sorbonne Université, UMR S 1127, CNRS UMR 722, Institut du Cerveau, Paris, France
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Chen Y, Zeng Q, Wang Y, Luo X, Sun Y, Zhang L, Liu X, Li K, Zhang M, Peng G. Characterizing Differences in Functional Connectivity Between Posterior Cortical Atrophy and Semantic Dementia by Seed-Based Approach. Front Aging Neurosci 2022; 14:850977. [PMID: 35572133 PMCID: PMC9099291 DOI: 10.3389/fnagi.2022.850977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/31/2022] [Indexed: 11/21/2022] Open
Abstract
Background Posterior cortical atrophy (PCA) and semantic dementia (SD) are focal syndromes involving different cerebral regions. This study aimed to demonstrate the existence of abnormal functional connectivity (FC) with an affected network in PCA and SD. Methods A total of 10 patients with PCA, 12 patients with SD, and 11 controls were recruited to undergo a detailed clinical history interview and physical examination, neuropsychological assessments, and PET/MRI scan. Seed-based FC analyses were conducted to construct FC in language network, visual network, and salience network. The two-sample t-test was performed to reveal distinct FC patterns in PCA and SD, and we further related the FC difference to cognition. Meanwhile, the uptake value of fluorodeoxyglucose in regions with FC alteration was also extracted for comparison. Results We found a global cognitive impairment in patients with PCA and SD. The results of FC analyses showed that patients with PCA present decreased FC in left precentral gyrus to left V1 and increased FC in right inferior frontal gyrus to right V1 in the visual network, right medial frontal gyrus and left fusiform to left anterior temporal lobe and post-superior temporal gyrus in the language network, and left superior temporal gyrus to left anterior insula in the salience network, which were related to cognitive function. Patients with SD had decreased FC from right superior frontal gyrus, right middle frontal gyrus and right superior frontal gyrus to left anterior temporal lobe, or post-superior temporal gyrus in the language network, as well as left superior frontal gyrus to right anterior insula in the salience network, positively relating to cognitive function, but increased FC in the right superior temporal gyrus to left anterior temporal lobe in the language network, and right insula and left anterior cingulum to right anterior insula in the salience network, negatively relating to cognitive function. Most of the regions with FC change in patients with PCA and SD had abnormal metabolism simultaneously. Conclusion Abnormal connectivity spread over the cortex involving language and salience networks was common in patients with PCA and SD, whereas FC change involving the visual network was unique to patients with PCA. The FC changes were matched for cognitive deficits.
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Affiliation(s)
- Yi Chen
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunyun Wang
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurology, Shengzhou People’s Hospital, Shengzhou, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Sun
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lumi Zhang
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Liu
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guoping Peng
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Tong J, Wang C, Liu H. Temporal information guided dynamic dual-tracer PET signal separation network. Med Phys 2022; 49:4585-4598. [PMID: 35396705 DOI: 10.1002/mp.15566] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 02/21/2021] [Accepted: 01/24/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The difficulty of dynamic dual-tracer positron emission tomography (PET) technology is to separate the complete single-tracer information from mixed dual-tracer. Traditional methods cannot separate single injection single-scan dynamic dual-tracer PET images. In this paper, we propose a deep learning framework based on gated recurrent unit (GRU) network and evaluate its performance with simulation experiments and realistic monkey data. METHODS The proposed single-scan dynamic dual-tracer PET image separation network consists of three parts, including encoder, separation and decoder module. Encoder part is to map the mixed time activity curves (TACs) from the low-dimensional space to the high-dimensional space to get mixed weight vector matrix. Separation part is to capture the temporal information of mixed weight vector matrix using bi-directional GRU (bi-GRU) layer to obtain the single-tracer masks, and the decoding part remaps the high-dimensional single-tracer weight vector matrix to the low-dimensional space to obtain two separated single tracers. RESULTS In the simulation experiments under different tracers, phantoms, noise levels, arterial input function (AIF) and k-parameter with Gaussian random, compared to the stacked auto encoder (SAE) network and traditional background subtraction method, GRU-based network has better performance with low bias and mean squared error (MSE). In the realistic study, the image results of GRU network have higher mean structural similarity (MSSIM), and peak signal to noise ratio (PSNR). CONCLUSIONS This study demonstrates the feasibility of temporal information guided neural network in single-injection single-scan dynamic dual-tracer PET images separation. The GRU-based network uses TAC temporal information without AIFs to make the separation results more robust and accurate, which significantly outperforms state-of-the-art method qualitatively and quantitatively. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Junyi Tong
- State Key Laboratory of Modern Optical Instrumentation, Zhejiang University, Hangzhou, 310027, China
| | - Chunxia Wang
- State Key Laboratory of Modern Optical Instrumentation, Zhejiang University, Hangzhou, 310027, China
| | - Huafeng Liu
- State Key Laboratory of Modern Optical Instrumentation, Zhejiang University, Hangzhou, 310027, China
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Chu M, Liu L, Wang J, Liu L, Kong Y, Jing D, Xie K, Cui Y, Cui B, Zhang J, Ye H, Li J, Wang L, Rosa-Neto P, Gauthier S, Wu L. Investigating the Roles of Anterior Cingulate in Behavioral Variant Frontotemporal Dementia: A PET/MRI Study. J Alzheimers Dis 2021; 84:1771-1779. [PMID: 34719498 PMCID: PMC8764589 DOI: 10.3233/jad-215127] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: The anterior cingulate cortex (ACC) seems to play an important role in behavioral deficits and executive dysfunctions in patients with behavioral variant frontotemporal dementia (bvFTD), while its specific and independent contribution requires clarification. Objective: To identify whether ACC abnormalities in gray matter (GM) volume and standardized uptake value ratio (SUVR) images are associated with disease severity of bvFTD, by analyzing hybrid T1 and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). Methods: We enrolled 21 bvFTD patients and 21 healthy controls in the study. Each subject underwent a hybrid PET/MRI study and a standardized neuropsychologic assessment battery. GM volume and SUVR are voxel-wise calculated and compared. Then we estimate the mean value inside ACC for further partial Pearson’s correlation to explore the association between GM volume/SUVR of the ACC and severity of behavioral deficit as well as executive dysfunction. Results: ACC was shown to be involved in both atrophy and hypometabolism patterns. The partial Pearson’s correlation analysis showed that the SUVR of the ACC was strongly correlated with frontal behavior inventory total score (left r = –0.85, right r = –0.85, p < 0.0001), disinhibition subscale score (left r = –0.72, p = 0.002; right = –0.75, p < 0.0001), and apathy subscale score (left = –0.87, right = –0.85, p < 0.0001). Conclusion: These findings demonstrated decreased ACC activity contributes to behavioral disturbances of both apathetic and disinhibition syndromes of bvFTD, which can be sensitively detected using 18F-FDG PET.
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Affiliation(s)
- Min Chu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Shenyang Fifth People Hospital, Shenyang, China
| | - Jingjuan Wang
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lin Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Second Hospital of ShanXi Medical University, Taiyuan, China
| | - Yu Kong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Donglai Jing
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Rongcheng People's Hospital, Hebei, China
| | - Kexin Xie
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yue Cui
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Bo Cui
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hong Ye
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Junjie Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lin Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Pedro Rosa-Neto
- McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Montreal, Canada
| | - Serge Gauthier
- McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Montreal, Canada
| | - Liyong Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Lorking N, Murray AD, O'Brien JT. The use of positron emission tomography/magnetic resonance imaging in dementia: A literature review. Int J Geriatr Psychiatry 2021; 36:1501-1513. [PMID: 34490651 DOI: 10.1002/gps.5586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/22/2021] [Accepted: 05/17/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Positron emission tomography-magnetic resonance imaging (PET/MRI) is an emerging hybrid imaging system in clinical nuclear medicine. Research demonstrates a comparative utility to current unimodal and hybrid methods, including PET-computed tomography (PET/CT), in several medical subspecialities such as neuroimaging. The aim of this review is to critically evaluate the literature from 2016 to 2021 using PET/MRI for the investigation of patients with mild cognitive impairment or dementia, and discuss the evidence base for widening its application into clinical practice. METHODS A comprehensive literature search using the PubMed database was conducted to retrieve studies using PET/MRI in relation to the topics of mild cognitive impairment, dementia, or Alzheimer's disease between January 2016 and January 2021. This search strategy enabled studies on all dementia types to be included in the analysis. Studies were required to have a minimum of 10 human subjects and incorporate simultaneous PET/MRI. RESULTS A total of 116 papers were retrieved, with 39 papers included in the final selection. These were broadly categorised into reviews (12), technical/methodological papers (11) and new data studies (16). For the current review, discussion focused on findings from the new data studies. CONCLUSIONS PET/MRI offers additional insight into the underlying anatomical, metabolic and functional changes associated with dementia when compared with unimodal methods and PET/CT, particularly relating to brain regions including the hippocampus and default mode network. Furthermore, the improved diagnostic utility of PET/MRI, as reported by radiologists, offers improved classification of dementia patients, with important implications for clinical management.
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Affiliation(s)
- Nicole Lorking
- School of Medicine, University of Aberdeen, Scotland, UK
| | | | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Soni N, Ora M, Bathla G, Nagaraj C, Boles Ponto LL, Graham MM, Saini J, Menda Y. Multiparametric magnetic resonance imaging and positron emission tomography findings in neurodegenerative diseases: Current status and future directions. Neuroradiol J 2021; 34:263-288. [PMID: 33666110 DOI: 10.1177/1971400921998968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Neurodegenerative diseases (NDDs) are characterized by progressive neuronal loss, leading to dementia and movement disorders. NDDs broadly include Alzheimer's disease, frontotemporal lobar degeneration, parkinsonian syndromes, and prion diseases. There is an ever-increasing prevalence of mild cognitive impairment and dementia, with an accompanying immense economic impact, prompting efforts aimed at early identification and effective interventions. Neuroimaging is an essential tool for the early diagnosis of NDDs in both clinical and research settings. Structural, functional, and metabolic imaging modalities, including magnetic resonance imaging (MRI) and positron emission tomography (PET), are widely available. They show encouraging results for diagnosis, monitoring, and treatment response evaluation. The current review focuses on the complementary role of various imaging modalities in relation to NDDs, the qualitative and quantitative utility of newer MRI techniques, novel radiopharmaceuticals, and integrated PET/MRI in the setting of NDDs.
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Affiliation(s)
- Neetu Soni
- University of Iowa Hospitals and Clinics, USA
| | - Manish Ora
- Department of Nuclear Medicine, SGPGIMS, India
| | - Girish Bathla
- Neuroradiology Department, University of Iowa Hospitals and Clinics, USA
| | - Chandana Nagaraj
- Department of Neuro Imaging and Interventional Radiology, NIMHANS, India
| | | | - Michael M Graham
- Division of Nuclear Medicine, University of Iowa Hospitals and Clinics, USA
| | - Jitender Saini
- Department of Neuro Imaging and Interventional Radiology, NIMHANS, India
| | - Yusuf Menda
- University of Iowa Hospitals and Clinics, USA
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