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Ryu CJ. Automatic lesion detection and segmentation in 18F-flutemetamol positron emission tomography images using deep learning. Biomed Eng Online 2022; 21:88. [PMID: 36539779 PMCID: PMC9768895 DOI: 10.1186/s12938-022-01058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Beta amyloid in the brain, which was originally confirmed by post-mortem examinations, can now be confirmed in living patients using amyloid positron emission tomography (PET) tracers, and the accuracy of diagnosis can be improved by beta amyloid plaque confirmation in patients. Amyloid deposition in the brain is often associated with the expression of dementia. Hence, it is important to identify the anatomically and functionally meaningful areas of the human brain cortex surface using PET to diagnose the possibility of developing dementia. In this study, we demonstrated the validity of automated 18F-flutemetamol PET lesion detection and segmentation based on a complete 2D U-Net convolutional neural network via masking treatment strategies. METHODS PET data were first normalized by volume and divided into five amyloid accumulation zones through axial, coronary, and thalamic slices. A single U-Net was trained using a divided dataset for one of these zones. Ground truth segmentations were obtained by manual delineation and thresholding (1.5 × background). RESULTS The following intersection over union values were obtained for the various slices in the verification dataset: frontal lobe axial/sagittal: 0.733/0.804; posterior cingulate cortex and precuneus coronal/sagittal: 0.661/0.726; lateral temporal lobe axial/coronal: 0.864/0.892; parietal lobe axial/coronal: 0.542/0.759; and striatum axial/sagittal: 0.679/0.752. The U-Net convolutional neural network architecture allowed fully automated 2D division of the 18F-flutemetamol PET brain images of Alzheimer's patients. CONCLUSIONS As dementia should be tested and evaluated in various ways, there is a need for artificial intelligence programs. This study can serve as a reference for future studies using auxiliary roles and research in Alzheimer's diagnosis.
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Affiliation(s)
- Chan Ju Ryu
- Department of Nuclear Medicine, Cha University Bundang Medical Center, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13496, Korea.
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2
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Cai H, Zou Y, Gao H, Huang K, Liu Y, Cheng Y, Liu Y, Zhou L, Zhou D, Chen Q. Radiological biomarkers of idiopathic normal pressure hydrocephalus: new approaches for detecting concomitant Alzheimer's disease and predicting prognosis. PSYCHORADIOLOGY 2022; 2:156-170. [PMID: 38665278 PMCID: PMC10917212 DOI: 10.1093/psyrad/kkac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 04/28/2024]
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a clinical syndrome characterized by cognitive decline, gait disturbance, and urinary incontinence. As iNPH often occurs in elderly individuals prone to many types of comorbidity, a differential diagnosis with other neurodegenerative diseases is crucial, especially Alzheimer's disease (AD). A growing body of published work provides evidence of radiological methods, including multimodal magnetic resonance imaging and positron emission tomography, which may help noninvasively differentiate iNPH from AD or reveal concurrent AD pathology in vivo. Imaging methods detecting morphological changes, white matter microstructural changes, cerebrospinal fluid circulation, and molecular imaging have been widely applied in iNPH patients. Here, we review radiological biomarkers using different methods in evaluating iNPH pathophysiology and differentiating or detecting concomitant AD, to noninvasively predict the possible outcome postshunt and select candidates for shunt surgery.
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Affiliation(s)
- Hanlin Cai
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yinxi Zou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Hui Gao
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Keru Huang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yu Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yuting Cheng
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yi Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Liangxue Zhou
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Qin Chen
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
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Goh ET, Lock C, Tan AJL, Tan BL, Liang S, Pillay R, Kumar S, Ahmad-Annuar A, Narayanan V, Kwok J, Tan YJ, Ng ASL, Tan EK, Czosnyka Z, Czosnyka M, Pickard JD, Keong NC. Clinical Outcomes After Ventriculo-Peritoneal Shunting in Patients With Classic vs. Complex NPH. Front Neurol 2022; 13:868000. [PMID: 35903111 PMCID: PMC9315242 DOI: 10.3389/fneur.2022.868000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Normal pressure hydrocephalus (NPH) is a neurological condition characterized by a clinical triad of gait disturbance, cognitive impairment, and urinary incontinence in conjunction with ventriculomegaly. Other neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, and vascular dementia share some overlapping clinical features. However, there is evidence that patients with comorbid NPH and Alzheimer's or Parkinson's disease may still exhibit good clinical response after CSF diversion. This study aims to evaluate clinical responses after ventriculo-peritoneal shunt (VPS) in a cohort of patients with coexisting NPH and neurodegenerative disease. Methods The study has two components; (i) a pilot study was performed that specifically focused upon patients with Complex NPH and following the inclusion of the Complex NPH subtype into consideration for the clinical NPH programme, (ii) a retrospective snapshot study was performed to confirm and characterize differences between Classic and Complex NPH patients being seen consecutively over the course of 1 year within a working subspecialist NPH clinic. We studied the characteristics of patients with Complex NPH, utilizing clinical risk stratification and multimodal biomarkers. Results There was no significant difference between responders and non-responders to CSF diversion on comorbidity scales. After VPS insertion, significantly more Classic NPH patients had improved cognition compared to Complex NPH patients (p = 0.005). Improvement in gait and urinary symptoms did not differ between the groups. 26% of the Classic NPH group showed global improvement of the triad, and 42% improved in two domains. Although only 8% showed global improvement of the triad, all Complex NPH patients improved in gait. Conclusions Our study has demonstrated that the presence of neurodegenerative disorders co-existing with NPH should not be the sole barrier to the consideration of high-volume tap test or lumbar drainage via a specialist NPH programme. Further characterization of distinct cohorts of NPH with differing degrees of CSF responsiveness due to overlay from neurodegenerative or comorbidity risk burden may aid toward more precise prognostication and treatment strategies. We propose a simplistic conceptual framework to describe NPH by its Classic vs. Complex subtypes to promote the clinical paradigm shift toward subspecialist geriatric neurosurgery by addressing needs for rapid screening tools at the clinical-research interface.
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Affiliation(s)
- Eng Tah Goh
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Christine Lock
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Audrey Jia Luan Tan
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Bee Ling Tan
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Sai Liang
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Robin Pillay
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Sumeet Kumar
- Department of Neuroradiology, National Neuroscience Institute, Singapore, Singapore
| | - Azlina Ahmad-Annuar
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vairavan Narayanan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Janell Kwok
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Yi Jayne Tan
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Adeline SL Ng
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Eng King Tan
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Zofia Czosnyka
- Neurosurgical Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Marek Czosnyka
- Neurosurgical Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - John D. Pickard
- Neurosurgical Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Nicole C. Keong
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- *Correspondence: Nicole C. Keong
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Kanno S, Ogawa KI, Kikuchi H, Toyoshima M, Abe N, Sato K, Miyazawa K, Oshima R, Ohtomo S, Arai H, Shibuya S, Suzuki K. Reduced default mode network connectivity relative to white matter integrity is associated with poor cognitive outcomes in patients with idiopathic normal pressure hydrocephalus. BMC Neurol 2021; 21:353. [PMID: 34517828 PMCID: PMC8436532 DOI: 10.1186/s12883-021-02389-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate whether default mode network (DMN) connectivity and brain white matter integrity at baseline were associated with severe cognitive impairments at baseline and poor cognitive outcomes after shunt placement in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Twenty consecutive patients with iNPH whose symptoms were followed for 6 months after shunt placement and 10 healthy controls (HCs) were enrolled. DMN connectivity and brain white matter integrity at baseline in the patients with iNPH and HCs were detected by using resting-state functional magnetic resonance imaging (MRI) with independent component analysis and diffusion tensor imaging, respectively, and these MRI indexes were compared between the patients with iNPH and HCs. Performance on neuropsychological tests for memory and executive function and on the gait test was assessed in the patients with iNPH at baseline and 6 months after shunt placement. We divided the patients with iNPH into the relatively preserved and reduced DMN connectivity groups using the MRI indexes for DMN connectivity and brain white matter integrity, and the clinical measures were compared between the relatively preserved and reduced DMN connectivity groups. RESULTS Mean DMN connectivity in the iNPH group was significantly lower than that in the HC group and was significantly positively correlated with Rey auditory verbal learning test (RAVLT) immediate recall scores and frontal assessment battery (FAB) scores. Mean fractional anisotropy of the whole-brain white matter skeleton in the iNPH group was significantly lower than that in the HC group. The reduced DMN connectivity group showed significantly worse performance on the RAVLT at baseline and significantly worse improvement in the RAVLT immediate recall and recognition scores and the FAB scores than the preserved DMN connectivity group. Moreover, the RAVLT recognition score highly discriminated patients with relatively preserved DMN connectivity from those with relatively reduced DMN connectivity. CONCLUSIONS Our findings indicated that iNPH patients with reduced DMN connectivity relative to the severity of brain white matter disruption have severe memory deficits at baseline and poorer cognitive outcomes after shunt placement. However, further larger-scale studies are needed to confirm these findings.
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Affiliation(s)
- Shigenori Kanno
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Miyagi, 980-8575, Sendai, Japan. .,Department of Neurology, South Miyagi Medical Center, Shibata, Japan.
| | - Kun-Ichi Ogawa
- Department of Radiology, South Miyagi Medical Center, Shibata, Japan
| | - Hiroaki Kikuchi
- Healthcare Center, South Miyagi Medical Center, Shibata, Japan
| | - Masako Toyoshima
- Department of Rehabilitation, South Miyagi Medical Center, Shibata, Japan
| | - Nobuhito Abe
- Kokoro Research Center, Kyoto University, Kyoto, Japan
| | - Kazushi Sato
- Department of Radiology, South Miyagi Medical Center, Shibata, Japan
| | - Koichi Miyazawa
- Department of Neurology, South Miyagi Medical Center, Shibata, Japan.,Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Ryuji Oshima
- Department of Neurology, South Miyagi Medical Center, Shibata, Japan
| | - Satoru Ohtomo
- Department of Neurosurgery, South Miyagi Medical Center, Shibata, Japan
| | - Hiroaki Arai
- Department of Neurosurgery, South Miyagi Medical Center, Shibata, Japan
| | - Satoshi Shibuya
- Department of Neurology, South Miyagi Medical Center, Shibata, Japan.,Department of Neurology, Moriyama Memorial Hospital, Edogawa, Japan
| | - Kyoko Suzuki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Miyagi, 980-8575, Sendai, Japan
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5
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Mallon DH, Malhotra P, Naik M, Edison P, Perry R, Carswell C, Win Z. The role of amyloid PET in patient selection for extra-ventricular shunt insertion for the treatment of idiopathic normal pressure hydrocephalus: A pooled analysis. J Clin Neurosci 2021; 90:325-331. [PMID: 34275571 DOI: 10.1016/j.jocn.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Idiopathic Normal Pressure Hydrocephalus (iNPH) can be effectively treated through shunt insertion. However, most shunted patients experience little or no clinical benefit, which suggests suboptimal patient selection. While contentious, multiple studies have reported poorer shunt outcomes associated with concomitant Alzheimer's disease. Prompted by this observation, multiple studies have assessed the role of amyloid PET, a specific test for Alzheimer's disease, in patient selection for shunting. METHODS A comprehensive literature search was performed to identify studies that assessed the association between amyloid PET result and the clinical response to shunting in patients with suspected iNPH. Pooled diagnostic statistics were calculated. RESULTS Across three relevant studies, a total of 38 patients with suspected iNPH underwent amyloid PET imaging and shunt insertion. Twenty-three patients had a positive clinical response to shunting. 18/28 (64.3%) of patients with a negative amyloid PET and 5/10 (50%) with a positive amyloid PET had a positive response to shunting. The pooled sensitivity, specificity and accuracy was 33.3%, 76.2% and 58.3%. None of these statistics reached statistical significance. CONCLUSION The results of this pooled analysis do not support the selection of patients with suspected iNPH for shunting on the basis of amyloid PET alone. However, due to small cohort sizes and weakness in study design, further high-quality studies are required to properly determine the role of amyloid PET in assessing this complex patient group.
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Affiliation(s)
- Dermot H Mallon
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; Imperial College London, Charing Cross Hospital, London, UK.
| | - Paresh Malhotra
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Mitesh Naik
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Paul Edison
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; Imperial College London, Charing Cross Hospital, London, UK
| | - Richard Perry
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Christopher Carswell
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; Imperial College London, Charing Cross Hospital, London, UK
| | - Zarni Win
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
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6
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NAKAJIMA M, YAMADA S, MIYAJIMA M, ISHII K, KURIYAMA N, KAZUI H, KANEMOTO H, SUEHIRO T, YOSHIYAMA K, KAMEDA M, KAJIMOTO Y, MASE M, MURAI H, KITA D, KIMURA T, SAMEJIMA N, TOKUDA T, KAIJIMA M, AKIBA C, KAWAMURA K, ATSUCHI M, HIRATA Y, MATSUMAE M, SASAKI M, YAMASHITA F, AOKI S, IRIE R, MIYAKE H, KATO T, MORI E, ISHIKAWA M, DATE I, ARAI H. Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus. Neurol Med Chir (Tokyo) 2021; 61:63-97. [PMID: 33455998 PMCID: PMC7905302 DOI: 10.2176/nmc.st.2020-0292] [Citation(s) in RCA: 190] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/13/2020] [Indexed: 01/18/2023] Open
Abstract
Among the various disorders that manifest with gait disturbance, cognitive impairment, and urinary incontinence in the elderly population, idiopathic normal pressure hydrocephalus (iNPH) is becoming of great importance. The first edition of these guidelines for management of iNPH was published in 2004, and the second edition in 2012, to provide a series of timely, evidence-based recommendations related to iNPH. Since the last edition, clinical awareness of iNPH has risen dramatically, and clinical and basic research efforts on iNPH have increased significantly. This third edition of the guidelines was made to share these ideas with the international community and to promote international research on iNPH. The revision of the guidelines was undertaken by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydrocephalus in conjunction with the Japanese Ministry of Health, Labour and Welfare research project. This revision proposes a new classification for NPH. The category of iNPH is clearly distinguished from NPH with congenital/developmental and acquired etiologies. Additionally, the essential role of disproportionately enlarged subarachnoid-space hydrocephalus (DESH) in the imaging diagnosis and decision for further management of iNPH is discussed in this edition. We created an algorithm for diagnosis and decision for shunt management. Diagnosis by biomarkers that distinguish prognosis has been also initiated. Therefore, diagnosis and treatment of iNPH have entered a new phase. We hope that this third edition of the guidelines will help patients, their families, and healthcare professionals involved in treating iNPH.
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Affiliation(s)
- Madoka NAKAJIMA
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shigeki YAMADA
- Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Shiga, Japan
| | - Masakazu MIYAJIMA
- Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Kazunari ISHII
- Department of Radiology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - Nagato KURIYAMA
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Kyoto, Japan
| | - Hiroaki KAZUI
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Hideki KANEMOTO
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takashi SUEHIRO
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kenji YOSHIYAMA
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masahiro KAMEDA
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Yoshinaga KAJIMOTO
- Department of Neurosurgery, Division of Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Mitsuhito MASE
- Department of Neurosurgery, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Hisayuki MURAI
- Department of Neurosurgery, Chibaken Saiseikai Narashino Hospital, Narashino, Chiba, Japan
| | - Daisuke KITA
- Department of Neurosurgery, Noto General Hospital, Nanao, Ishikawa, Japan
| | - Teruo KIMURA
- Department of Neurosurgery, Kitami Red Cross Hospital, Kitami, Hokkaido, Japan
| | - Naoyuki SAMEJIMA
- Department of Neurosurgery, Tokyo Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Tokyo, Japan
| | - Takahiko TOKUDA
- Department of Functional Brain Imaging Research, National Institute of Radiological Science, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, Japan
| | - Mitsunobu KAIJIMA
- Department of Neurosurgery, Hokushinkai Megumino Hospital, Eniwa, Hokkaido, Japan
| | - Chihiro AKIBA
- Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Kaito KAWAMURA
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Masamichi ATSUCHI
- Normal Pressure Hydrocephalus Center, Jifukai Atsuchi Neurosurgical Hospital, Kagoshima, Kagoshima, Japan
| | - Yoshihumi HIRATA
- Department of Neurosurgery, Kumamoto Takumadai Hospital, Kumamoto, Kumamoto, Japan
| | - Mitsunori MATSUMAE
- Department of Neurosurgery at Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Makoto SASAKI
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Iwate, Japan
| | - Fumio YAMASHITA
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Iwate, Japan
| | - Shigeki AOKI
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Ryusuke IRIE
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroji MIYAKE
- Nishinomiya Kyoritsu Rehabilitation Hospital, Nishinomiya, Hyogo, Japan
| | - Takeo KATO
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Etsuro MORI
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan
| | - Masatsune ISHIKAWA
- Department of Neurosurgery and Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto, Kyoto, Japan
| | - Isao DATE
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Hajime ARAI
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - The research committee of idiopathic normal pressure hydrocephalus
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Shiga, Japan
- Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
- Department of Radiology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Kyoto, Japan
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
- Department of Neurosurgery, Division of Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
- Department of Neurosurgery, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Aichi, Japan
- Department of Neurosurgery, Chibaken Saiseikai Narashino Hospital, Narashino, Chiba, Japan
- Department of Neurosurgery, Noto General Hospital, Nanao, Ishikawa, Japan
- Department of Neurosurgery, Kitami Red Cross Hospital, Kitami, Hokkaido, Japan
- Department of Neurosurgery, Tokyo Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Tokyo, Japan
- Department of Functional Brain Imaging Research, National Institute of Radiological Science, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, Japan
- Department of Neurosurgery, Hokushinkai Megumino Hospital, Eniwa, Hokkaido, Japan
- Normal Pressure Hydrocephalus Center, Jifukai Atsuchi Neurosurgical Hospital, Kagoshima, Kagoshima, Japan
- Department of Neurosurgery, Kumamoto Takumadai Hospital, Kumamoto, Kumamoto, Japan
- Department of Neurosurgery at Tokai University School of Medicine, Isehara, Kanagawa, Japan
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Iwate, Japan
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
- Nishinomiya Kyoritsu Rehabilitation Hospital, Nishinomiya, Hyogo, Japan
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan
- Department of Neurosurgery and Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto, Kyoto, Japan
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7
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Mattoli MV, Treglia G, Calcagni ML, Mangiola A, Anile C, Trevisi G. Usefulness of Brain Positron Emission Tomography with Different Tracers in the Evaluation of Patients with Idiopathic Normal Pressure Hydrocephalous. Int J Mol Sci 2020; 21:E6523. [PMID: 32906629 PMCID: PMC7555923 DOI: 10.3390/ijms21186523] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 11/24/2022] Open
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is the only form of dementia that can be cured by surgery. Its diagnosis relies on clinical and radiological criteria. Identifying patients who can benefit from surgery is challenging, as other neurological diseases can be concomitant or mimic iNPH. We performed a systematic review on the role of positron emission tomography (PET) in iNPH. We retrieved 35 papers evaluating four main functional aspects with different PET radiotracers: (1) PET with amyloid tracers, revealing Alzheimer's disease (AD) pathology in 20-57% of suspected iNPH patients, could be useful in predictions of surgical outcome. (2) PET with radiolabeled water as perfusion tracer showed a global decreased cerebral blood flow (CBF) and regional reduction of CBF in basal ganglia in iNPH; preoperative perfusion parameters could predict surgical outcome. (3) PET with 2-Deoxy-2-[18F]fluoroglucose ([18F]FDG ) showed a global reduction of glucose metabolism without a specific cortical pattern and a hypometabolism in basal ganglia; [18F]FDG PET may identify a coexisting neurodegenerative disease, helping in patient selection for surgery; postsurgery increase in glucose metabolism was associated with clinical improvement. (4) Dopaminergic PET imaging showed a postsynaptic D2 receptor reduction and striatal upregulation of D2 receptor after treatment, associated with clinical improvement. Overall, PET imaging could be a useful tool in iNPH diagnoses and treatment response.
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Affiliation(s)
- Maria Vittoria Mattoli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” Chieti-Pescara University, 66100 Chieti, Italy; (M.V.M.); (A.M.)
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Academic Education, Research and Innovation Area, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Maria Lucia Calcagni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, UOC di Medicina Nucleare, 00168 Rome, Italy;
- Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Annunziato Mangiola
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” Chieti-Pescara University, 66100 Chieti, Italy; (M.V.M.); (A.M.)
- Neurosurgery Unit, Santo Spirito Hospital, 65124 Pescara, Italy;
| | - Carmelo Anile
- Istituto di Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Gianluca Trevisi
- Neurosurgery Unit, Santo Spirito Hospital, 65124 Pescara, Italy;
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8
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Liu JT, Su PH. The efficacy and limitation of lumboperitoneal shunt in normal pressure hydrocephalus. Clin Neurol Neurosurg 2020; 193:105748. [PMID: 32155527 DOI: 10.1016/j.clineuro.2020.105748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/17/2020] [Accepted: 02/23/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate whether the efficacy of the lumbar-peritoneal (LP) shunt is sustainable, we measured the outcomes of patients with idiopathic NPH (iNPH) preoperatively and postoperatively. PATIENTS AND METHODS We retrospective reviewed records of 58 patients with iNPH from 2013 to 2015. Exclusion of 7 patients expired, 1 patient shunt infection, and 8 patients was loss of follow-up. In the remaining 42 patients, the mood, talking response, movement, attention, recalling memory, and mini-mental state examination (MMSE), representing patient outcomes, were measured. All of whom were follow-up for 3 years. RESULTS Mood (1.91 ± 0.30), talking response (1.98 ± 0.15), movement (1.71 ± 0.51), attention (1.95 ± 0.22), and recalling memory (1.86 ± 0.35) were significantly improved after surgery (1 week;p < 0.0001). However, the indicators significantly declined after 3 years (mood: 0.31 ± 0.52, talking response: 0.50 ± 0.59, movement: 0.17 ± 0.38, attention: 0.40 ± 0.59, recalling memory: 0.21 ± 0.42). The MMSE was also significantly improved after 3 months of surgery (17.9 5 ± 2.80 vs. 25.02 ± 3.36; p < 0.0001). However, it declined after 3 years (17.83 ± 3.66; p = 0.83). CONCLUSION The iNPH is considered potentially reversible. Our data supported that the LP shunt was efficient in the short term. However, the neurological degeneration was still progressive.
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Affiliation(s)
- Jung-Tung Liu
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Pen-Hua Su
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; Department of Pediatrics and Genetics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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9
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Leinonen V, Rauramaa T, Johansson J, Bottelbergs A, Tesseur I, van der Ark P, Pemberton D, Koivisto AM, Jääskeläinen JE, Hiltunen M, Herukka SK, Blennow K, Zetterberg H, Jokinen P, Rokka J, Helin S, Haaparanta-Solin M, Solin O, Okamura N, Kolb HC, Rinne JO. S-[18F]THK-5117-PET and [11C]PIB-PET Imaging in Idiopathic Normal Pressure Hydrocephalus in Relation to Confirmed Amyloid-β Plaques and Tau in Brain Biopsies. J Alzheimers Dis 2019; 64:171-179. [PMID: 29865068 DOI: 10.3233/jad-180071] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Detection of pathological tau aggregates could facilitate clinical diagnosis of Alzheimer's disease (AD) and monitor drug effects in clinical trials. S-[18F]THK-5117 could be a potential tracer to detect pathological tau deposits in brain. However, no previous study have correlated S-[18F]THK-5117 uptake in PET with brain biopsy verified tau pathology in vivo. OBJECTIVE Here we aim to evaluate the association between cerebrospinal fluid (CSF) AD biomarkers, S-[18F]THK-5117, and [11C]PIB PET against tau and amyloid lesions in brain biopsy. METHODS Fourteen patients with idiopathic normal pressure hydrocephalus (iNPH) with previous shunt surgery including right frontal cortical brain biopsy and CSF Aβ1 - 42, total tau, and P-tau181 measures, underwent brain MRI, [11C]PIB PET, and S-[18F]THK-5117 PET imaging. RESULTS Seven patients had amyloid-β (Aβ, 4G8) plaques, two both Aβ and phosphorylated tau (Pτ, AT8) and one only Pτ in biopsy. As expected, increased brain biopsy Aβ was well associated with higher [11C]PIB uptake in PET. However, S-[18F]THK-5117 uptake did not show any statistically significant correlation with either brain biopsy Pτ or CSF P-tau181 or total tau. CONCLUSIONS S-[18F]THK-5117 lacked clear association with neuropathologically verified tau pathology in brain biopsy probably, at least partially, due to off-target binding. Further studies with larger samples of patients with different tau tracers are urgently needed. The detection of simultaneous Aβ and tau pathology in iNPH is important since that may indicate poorer and especially shorter response for CSF shunt surgery compared with no pathology.
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Affiliation(s)
- Ville Leinonen
- Institute of Clinical Medicine - Neurosurgery, University of Eastern Finland and Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland.,Unit of ClinicalNeuroscience, Neurosurgery, University of Oulu and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Tuomas Rauramaa
- Institute of Clinical Medicine - Pathology, University of Eastern Finland andDepartment of Pathology, Kuopio University Hospital, Kuopio, Finland
| | | | - Astrid Bottelbergs
- Janssen Research and Development, A Division of Janssen Pharmaceutica, Beerse, Belgium
| | - Ina Tesseur
- Janssen Research and Development, A Division of Janssen Pharmaceutica, Beerse, Belgium
| | - Peter van der Ark
- Janssen Research and Development, A Division of Janssen Pharmaceutica, Beerse, Belgium
| | - Darrel Pemberton
- Janssen Research and Development, A Division of Janssen Pharmaceutica, Beerse, Belgium
| | - Anne M Koivisto
- Institute of Clinical Medicine - Neurology, Universityof Eastern Finland and Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Juha E Jääskeläinen
- Institute of Clinical Medicine - Neurosurgery, University of Eastern Finland and Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland
| | - Mikko Hiltunen
- Institute of Clinical Medicine - Neurology, Universityof Eastern Finland and Department of Neurology, Kuopio University Hospital, Kuopio, Finland.,Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine - Neurology, Universityof Eastern Finland and Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska Academy Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska Academy Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.,Department of MolecularNeuroscience, Institute of Neurology, University College London, Queen, Square, UK.,UK DementiaResearch Institute, London, UK
| | - Pekka Jokinen
- Turku PET Centre, University of Turku, Turku, Finland.,Department of Neurosurgery, Turku University Hospital, Turku, Finland
| | - Johanna Rokka
- Radiopharmaceutical Chemistry Laboratory, Turku PET Centre, University of Turku, Turku, Finland.,Athinoula A. Martinos Center, Department of Radiology, Massachusetts GeneralHospital, Harvard Medical School, Charlestown, MA, USA
| | - Semi Helin
- Radiopharmaceutical Chemistry Laboratory, Turku PET Centre, University of Turku, Turku, Finland
| | - Merja Haaparanta-Solin
- PET Preclinical Imaging Laboratory, Turku PET Centre, University of Turku, Turku, Finland.,MediCity Research Laboratory, University of Turku, Turku, Finland
| | - Olof Solin
- Radiopharmaceutical Chemistry Laboratory, Turku PET Centre, University of Turku, Turku, Finland.,Department of Chemistry, University of Turku, Turku, Finland.,Accelerator Laboratory, Turku PET Centre, Åbo Akademi University, Turku, Finland
| | | | | | - Juha O Rinne
- Turku PET Centre, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
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10
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Abu Hamdeh S, Virhammar J, Sehlin D, Alafuzoff I, Cesarini KG, Marklund N. Brain tissue Aβ42 levels are linked to shunt response in idiopathic normal pressure hydrocephalus. J Neurosurg 2019; 130:121-129. [PMID: 29350601 DOI: 10.3171/2017.7.jns171005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/24/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors conducted a study to test if the cortical brain tissue levels of soluble amyloid beta (Aβ) reflect the propensity of cortical Aβ aggregate formation and may be an additional factor predicting surgical outcome following idiopathic normal pressure hydrocephalus (iNPH) treatment. METHODS Highly selective ELISAs (enzyme-linked immunosorbent assays) were used to quantify soluble Aβ40, Aβ42, and neurotoxic Aβ oligomers/protofibrils, associated with Aβ aggregation, in cortical biopsy samples obtained in patients with iNPH (n = 20), sampled during ventriculoperitoneal (VP) shunt surgery. Patients underwent pre- and postoperative (3-month) clinical assessment with a modified iNPH scale. The preoperative CSF biomarkers and the levels of soluble and insoluble Aβ species in cortical biopsy samples were analyzed for their association with a favorable outcome following the VP shunt procedure, defined as a ≥ 5-point increase in the iNPH scale. RESULTS The brain tissue levels of Aβ42 were negatively correlated with CSF Aβ42 (Spearman’s r = -0.53, p < 0.05). The Aβ40, Aβ42, and Aβ oligomer/protofibril levels in cortical biopsy samples were higher in patients with insoluble cortical Aβ aggregates (p < 0.05). The preoperative CSF Aβ42 levels were similar in patients responding (n = 11) and not responding (n = 9) to VP shunt treatment at 3 months postsurgery. In contrast, the presence of cortical Aβ aggregates and high brain tissue Aβ42 levels were associated with a poor outcome following VP shunt treatment (p < 0.05). CONCLUSIONS Brain tissue measurements of soluble Aβ species are feasible. Since high Aβ42 levels in cortical biopsy samples obtained in patients with iNPH indicated a poor surgical outcome, tissue levels of Aβ species may be associated with the clinical response to shunt treatment.
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Affiliation(s)
- Sami Abu Hamdeh
- 1Department of Neuroscience, Section of Neurosurgery, Uppsala University
| | - Johan Virhammar
- 2Department of Neuroscience, Neurology, Uppsala University Hospital, Uppsala University
| | - Dag Sehlin
- 3Department of Public Health and Caring Sciences/Geriatrics, Uppsala University; and
| | - Irina Alafuzoff
- 4Department of Pathology, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | | | - Niklas Marklund
- 1Department of Neuroscience, Section of Neurosurgery, Uppsala University
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11
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Scheinin NM, Gardberg M, Röyttä M, Rinne JO. Negative 11C-PIB PET Predicts Lack of Alzheimer's Disease Pathology in Postmortem Examination. J Alzheimers Dis 2018; 63:79-85. [PMID: 29614642 PMCID: PMC5900551 DOI: 10.3233/jad-170569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 11/16/2022]
Abstract
Our aim was to assess whether in vivo11C-PIB negative memory-impaired subjects may nonetheless exhibit brain Alzheimer's disease (AD) pathology. We re-evaluated the PET images and systematically characterized the postmortem neuropathology of six individuals who had undergone clinically indicated amyloid PET. The single case with negligible amyloid-β (Aβ) pathology had Lewy body disease, where concomitant AD changes are often seen. Further, the subject's plaques were predominantly diffuse. The predictive value of a negative 11C-PIB scan appears to be good, even in memory-impaired populations. Our results suggest that considerable neuritic Aβ plaque pathology in the absence of specific/cortical 11C-PIB binding upon PET is unlikely.
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Affiliation(s)
- Noora M. Scheinin
- Turku PET Centre, University of Turku, Turku, Finland
- Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Maria Gardberg
- Department of Pathology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Matias Röyttä
- Department of Pathology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Juha O. Rinne
- Turku PET Centre, University of Turku, Turku, Finland
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
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12
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Jang H, Park SB, Kim Y, Kim KW, Lee JI, Kim ST, Lee KH, Kang ES, Choe YS, Seo SW, Kim HJ, Kim YJ, Yoon CW, Na DL. Prognostic value of amyloid PET scan in normal pressure hydrocephalus. J Neurol 2017; 265:63-73. [PMID: 29128930 DOI: 10.1007/s00415-017-8650-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 11/27/2022]
Abstract
Amyloid positron emission tomography ([18F] florbetaben (FBB) PET) can be used to determine concomitant Alzheimer's disease (AD) in idiopathic normal pressure hydrocephalus (iNPH) patients. FBB PET scans and the tap test were performed in 31 patients with clinically suspected iNPH, and amyloid positive (iNPH/FBB+) and negative (iNPH/FBB-) groups were compared with respect to clinical characteristics. We evaluated prognostic value of FBB PET scans by analyzing the response to the tap test using a linear mixed model. We also performed a multivariable regression analysis to investigate whether amyloid PET positivity can predict the positive tap test response independent of other AD biomarkers. The results showed that the iNPH/FBB+ group (7/31, 22.6%) had a higher percentage of APOE4 carriers, lower Aβ42, higher CSF t-tau, and p-tau/Aβ42 ratio than the iNPH/FBB- group (24/31, 77.4%), while the two groups did not differ in imaging characteristics. The iNPH/FBB- group had a higher percentage of tap responders and showed a greater improvement in gait scores after the tap test than the iNPH/FBB+ group (group-tap test effect interaction, p = 0.035). A multivariable logistic regression analysis showed that amyloid positivity on PET scans (OR 0.03, p = 0.029) and CSF p-tau (OR 0.87, p = 0.044) were independently associated with the positive tap test response. Among 21 tap responders in the iNPH/FBB- group, 14 patients received shunt surgery and 12/14 (85.7%) patients showed symptom improvement. Our findings suggest that amyloid PET scans can help determine which iNPH patients will benefit from shunt surgery by discriminating concomitant AD.
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Affiliation(s)
- Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Seong Beom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Yeshin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Ko Woon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jung Il Lee
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Han Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Suk Kang
- Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeong Sim Choe
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Cindy W Yoon
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea.
- Neuroscience Center, Samsung Medical Center, Seoul, Korea.
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
- Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul, Korea.
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13
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Cressier D, Dhilly M, Cao Pham TT, Fillesoye F, Gourand F, Maïza A, Martins AF, Morfin JF, Geraldes CFGC, Tóth É, Barré L. Gallium-68 Complexes Conjugated to Pittsburgh Compound B: Radiolabeling and Biological Evaluation. Mol Imaging Biol 2017; 18:334-43. [PMID: 26543029 DOI: 10.1007/s11307-015-0906-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this work is to develop an efficient and fully automated radiosynthesis of three derivatives of the Pittsburgh compound B labeled with gallium-68 for the detection of amyloid plaques. PROCEDURES The radiolabeling of the precursors and purification of the radiolabeled agents by high pressure liquid chromatography has been studied prior to their in vitro and in vivo evaluations. RESULTS The complete process led, in 50 min, to pure Ga-68 products in a 12-38 % yield and with appreciable specific radioactivity (SRA, 85-168 GBq/μmol) which enabled us to demonstrate a considerable in vivo stability of the products. Unfortunately, this result was associated with a poor blood-brain barrier (BBB) permeability and a limited uptake of our compounds by amyloid deposits was observed by in vitro autoradiography. CONCLUSION Although we have not yet identified a compound able to significantly mark cerebral amyloidosis, this present investigation will likely contribute to the development of more successful Ga-68 radiotracers.
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Affiliation(s)
- Damien Cressier
- CEA, I2BM, LDM-TEP, UMR 6301 ISTCT, GIP Cyceron, 14074, Caen, France. .,CNRS, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France. .,Université de Caen Normandie, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France.
| | - Martine Dhilly
- CEA, I2BM, LDM-TEP, UMR 6301 ISTCT, GIP Cyceron, 14074, Caen, France.,CNRS, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France.,Université de Caen Normandie, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France
| | - Thang T Cao Pham
- CEA, I2BM, LDM-TEP, UMR 6301 ISTCT, GIP Cyceron, 14074, Caen, France.,CNRS, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France.,Université de Caen Normandie, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France
| | - Fabien Fillesoye
- CEA, I2BM, LDM-TEP, UMR 6301 ISTCT, GIP Cyceron, 14074, Caen, France.,CNRS, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France.,Université de Caen Normandie, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France
| | - Fabienne Gourand
- CEA, I2BM, LDM-TEP, UMR 6301 ISTCT, GIP Cyceron, 14074, Caen, France.,CNRS, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France.,Université de Caen Normandie, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France
| | - Auriane Maïza
- CEA, I2BM, LDM-TEP, UMR 6301 ISTCT, GIP Cyceron, 14074, Caen, France.,CNRS, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France.,Université de Caen Normandie, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France
| | - André F Martins
- Centre de Biophysique Moléculaire UPR 4301, CNRS, Université d'Orléans, 45071, Orléans, France.,Department of Life Sciences and Coimbra Chemistry Center, Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
| | - Jean-François Morfin
- Centre de Biophysique Moléculaire UPR 4301, CNRS, Université d'Orléans, 45071, Orléans, France
| | - Carlos F G C Geraldes
- Department of Life Sciences and Coimbra Chemistry Center, Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
| | - Éva Tóth
- Centre de Biophysique Moléculaire UPR 4301, CNRS, Université d'Orléans, 45071, Orléans, France
| | - Louisa Barré
- CEA, I2BM, LDM-TEP, UMR 6301 ISTCT, GIP Cyceron, 14074, Caen, France.,CNRS, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France.,Université de Caen Normandie, UMR 6301 ISTCT, LDM-TEP, GIP Cyceron, 14074, Caen, France
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14
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Salloway S, Gamez JE, Singh U, Sadowsky CH, Villena T, Sabbagh MN, Beach TG, Duara R, Fleisher AS, Frey KA, Walker Z, Hunjan A, Escovar YM, Agronin ME, Ross J, Bozoki A, Akinola M, Shi J, Vandenberghe R, Ikonomovic MD, Sherwin PF, Farrar G, Smith APL, Buckley CJ, Thal DR, Zanette M, Curtis C. Performance of [ 18F]flutemetamol amyloid imaging against the neuritic plaque component of CERAD and the current (2012) NIA-AA recommendations for the neuropathologic diagnosis of Alzheimer's disease. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 9:25-34. [PMID: 28795133 PMCID: PMC5536824 DOI: 10.1016/j.dadm.2017.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction Performance of the amyloid tracer [18F]flutemetamol was evaluated against three pathology standard of truth (SoT) measures including neuritic plaques (CERAD “original” and “modified” and the amyloid component of the 2012 NIA-AA guidelines). Methods After [18F]flutemetamol imaging, 106 end-of-life patients who died underwent postmortem brain examination for amyloid plaque load. Blinded positron emission tomography scan interpretations by five independent electronically trained readers were compared with pathology measures. Results By SoT, sensitivity and specificity of majority image interpretations were, respectively, 91.9% and 87.5% with “original CERAD,” 90.8% and 90.0% with “modified CERAD,” and 85.7% and 100% with the 2012 NIA-AA criteria. Discussion The high accuracy of either CERAD criteria suggests that [18F]flutemetamol predominantly reflects neuritic amyloid plaque density. However, the use of CERAD criteria as the SoT can result in some false-positive results because of the presence of diffuse plaques, which are accounted for when the positron emission tomography read is compared with the 2012 NIA-AA criteria. Determination of the accuracy of [18F]flutemetamol image read against Aβ at autopsy. High sensitivity and specificity to 3 neuropathologic criteria as Standards of Truth. Images are 100% specific when the SoT reflects both neuritic and diffuse plaques. This study has the largest autopsy validation cohort for Aβ PET tracers to date.
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Affiliation(s)
- Stephen Salloway
- Neurology and the Memory and Aging Program, Butler Hospital, Warren Alpert Medical School, Brown University, Providence, RI, USA.,Department of Neurology and Psychiatry, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | | | - Carl H Sadowsky
- Division of Neurology, Nova SE University, Fort Lauderdale, FL, USA
| | | | - Marwan N Sabbagh
- Division of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
| | | | - Ranjan Duara
- Mount Sinai Medical Center, Wien Center for Alzheimer's Disease and Memory Disorders, Miami Beach, FL, USA
| | | | - Kirk A Frey
- Department of Radiology (Nuclear Medicine), University of Michigan, Ann Arbor, MI, USA
| | - Zuzana Walker
- Division of Psychiatry, University College London and North Essex Partnership University NHS Foundation Trust, London, UK
| | - Arvinder Hunjan
- Hertfordshire Partnership University NHS Foundation Trust, Essex, UK
| | | | - Marc E Agronin
- Mental Health and Clinical Research, Miami Jewish Health Systems, Miami, FL, USA.,University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joel Ross
- Memory Enhancement Center, Eatontown, NJ, USA
| | - Andrea Bozoki
- Department of Neurology, Cognitive and Geriatric Neurology Team, Michigan State University, East Lansing, MI, USA
| | | | - Jiong Shi
- Division of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Rik Vandenberghe
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Gill Farrar
- Life Sciences, GE Healthcare, Amersham, Buckinghamshire, UK
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15
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Validation of an electronic image reader training programme for interpretation of [18F]flutemetamol β-amyloid PET brain images. Nucl Med Commun 2017; 38:234-241. [PMID: 27984539 PMCID: PMC5318150 DOI: 10.1097/mnm.0000000000000633] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives An electronic training programme (ETP) was developed for interpretation of images during routine clinical use of the PET amyloid imaging agent [18F]flutemetamol injection (VIZAMYL). This study was carried out to validate the ETP. Materials and methods Five nuclear medicine technologists (NMTs) and five readers previously inexperienced in amyloid image interpretation were required to self-train using the ETP and pass a test to participate. A total of 305 [18F]flutemetamol PET images were then tested as the validation set, following preassessment and reorientation (where required) by one of five NMTs. Next, a new set of readers blinded to clinical information independently assessed all 305 images. Images had been acquired in previous studies from patients representing the full spectrum of cognitive capacity. When available, a standard of truth determined by histopathology or clinical history was used to derive sensitivity and specificity for image interpretation from this validation set. Randomly selected images (n=29) were read in duplicate to measure intrareader reproducibility. Images were read first without, and subsequently with anatomic images, if available. Results All NMTs and all readers scored 100% on the qualifying test. The interpretation of 135 cases without anatomic image support resulted in sensitivity ranging from 84% to 94% (majority 94%, median 92%) and specificity ranging from 77% to 96% (majority 92%, median 81%). Inter-reader agreement was very high, with most κ scores more than 0.8. Intrareader reproducibility ranged from 93 to 100%. Conclusion The self-guided ETP effectively trained new amyloid PET image readers to accurately and reproducibly interpret [18F]flutemetamol PET images.
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16
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Beach TG, Thal DR, Zanette M, Smith A, Buckley C. Detection of Striatal Amyloid Plaques with [18F]flutemetamol: Validation with Postmortem Histopathology. J Alzheimers Dis 2017; 52:863-73. [PMID: 27031469 DOI: 10.3233/jad-150732] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Amyloid imaging is limited by an inconsistent relationship between cerebral cortex amyloid- β (Aβ) plaques and dementia. Autopsy studies suggest that Aβ plaques first appear in the cerebral cortex while subcortical plaques are present only later in the disease course. The presence of abundant plaques in both cortex and striatum is more strongly correlated with the presence of dementia than cortical Aβ plaques alone. Additionally, detection of striatal plaques may allow, for the first time, pathology-based clinical staging of AD. Striatal plaques are reportedly identifiable by amyloid imaging but the accuracy and reliability of striatal amyloid imaging has never been tested against postmortem histopathology. To determine this, we correlated the presence of histopathologically-demonstrated striatal Aβ deposits with a visually positive panel consensus decision of a positive [18F]flutemetamol striatal PET signal in 68 subjects that later came to autopsy. The sensitivity of [18F]flutemetamol PET striatal amyloid imaging, for several defined density levels of histological striatal Aβ deposits, ranged between 69% and 87% while the specificity ranged between 96% and 100%. Sensitivity increased with higher histological density thresholds while the reverse was found for specificity. In general, as compared with PET alone, PET with CT had slightly higher sensitivities but slightly lower specificities. In conclusion, amyloid imaging of the striatum with [18F]flutemetamol PET has reasonable accuracy for the detection of histologically-demonstrated striatal Aβ plaques when present at moderate or frequent densities. Amyloid imaging of the cerebral cortex and striatum together may allow for a more accurate clinicopathological diagnosis of AD and enable pathology-based clinical staging of AD.
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Affiliation(s)
| | - Dietmar Rudolf Thal
- Institute of Pathology, Laboratory of Neuropathology, Center for Biomedical Research, University of Ulm, Ulm, Germany
| | | | - Adrian Smith
- GE Healthcare, The Grove Centre, White Lion Rd, Amersham, UK
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Ikonomovic MD, Buckley CJ, Heurling K, Sherwin P, Jones PA, Zanette M, Mathis CA, Klunk WE, Chakrabarty A, Ironside J, Ismail A, Smith C, Thal DR, Beach TG, Farrar G, Smith APL. Post-mortem histopathology underlying β-amyloid PET imaging following flutemetamol F 18 injection. Acta Neuropathol Commun 2016; 4:130. [PMID: 27955679 PMCID: PMC5154022 DOI: 10.1186/s40478-016-0399-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 11/29/2016] [Indexed: 01/19/2023] Open
Abstract
In vivo imaging of fibrillar β-amyloid deposits may assist clinical diagnosis of Alzheimer's disease (AD), aid treatment selection for patients, assist clinical trials of therapeutic drugs through subject selection, and be used as an outcome measure. A recent phase III trial of [18F]flutemetamol positron emission tomography (PET) imaging in 106 end-of-life subjects demonstrated the ability to identify fibrillar β-amyloid by comparing in vivo PET to post-mortem histopathology. Post-mortem analyses demonstrated a broad and continuous spectrum of β-amyloid pathology in AD and other dementing and non-dementing disease groups. The GE067-026 trial demonstrated 91% sensitivity and 90% specificity of [18F]flutemetamol PET by majority read for the presence of moderate or frequent plaques. The probability of an abnormal [18F]flutemetamol scan increased with neocortical plaque density and AD diagnosis. All dementia cases with non-AD neurodegenerative diseases and those without histopathological features of β-amyloid deposits were [18F]flutemetamol negative. Majority PET assessments accurately reflected the amyloid plaque burden in 90% of cases. However, ten cases demonstrated a mismatch between PET image interpretations and post-mortem findings. Although tracer retention was best associated with amyloid in neuritic plaques, amyloid in diffuse plaques and cerebral amyloid angiopathy best explain three [18F]flutemetamol positive cases with mismatched (sparse) neuritic plaque burden. Advanced cortical atrophy was associated with the seven false negative [18F]flutemetamol images. The interpretation of images from pathologically equivocal cases was associated with low reader confidence and inter-reader agreement. Our results support that amyloid in neuritic plaque burden is the primary form of β-amyloid pathology detectable with [18F]flutemetamol PET imaging. ClinicalTrials.gov NCT01165554. Registered June 21, 2010; NCT02090855. Registered March 11, 2014.
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18
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Nordeman P, Johansson LBG, Bäck M, Estrada S, Hall H, Sjölander D, Westermark GT, Westermark P, Nilsson L, Hammarström P, Nilsson KPR, Antoni G. (11)C and (18)F Radiolabeling of Tetra- and Pentathiophenes as PET-Ligands for Amyloid Protein Aggregates. ACS Med Chem Lett 2016; 7:368-73. [PMID: 27096043 DOI: 10.1021/acsmedchemlett.5b00309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 02/18/2016] [Indexed: 12/29/2022] Open
Abstract
Three oligothiophenes were evaluated as PET ligands for the study of local and systemic amyloidosis ex vivo using tissue from patients with amyloid deposits and in vivo using healthy animals and PET-CT. The ex vivo binding studies revealed that all three labeled compounds bound specifically to human amyloid deposits. Specific binding was found in the heart, kidney, liver, and spleen. To verify the specificity of the oligothiophenes toward amyloid deposits, tissue sections with amyloid pathology were stained using the fluorescence exhibited by the compounds and evaluated with multiphoton microscopy. Furthermore, a in vivo monkey PET-CT study showed very low uptake in the brain, pancreas, and heart of the healthy animal indicating low nonspecific binding to healthy tissue. The biological evaluations indicated that this is a promising group of compounds for the visualization of systemic and localized amyloidosis.
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Affiliation(s)
- Patrik Nordeman
- Preclinical
PET Platform, Department of Medicinal Chemistry, Uppsala University, Uppsala SE-75123, Sweden
| | | | - Marcus Bäck
- Department
of Chemistry, IFM, Linköping University, Linköping 581 83, Sweden
| | - Sergio Estrada
- Preclinical
PET Platform, Department of Medicinal Chemistry, Uppsala University, Uppsala SE-75123, Sweden
| | - Håkan Hall
- Preclinical
PET Platform, Department of Medicinal Chemistry, Uppsala University, Uppsala SE-75123, Sweden
| | - Daniel Sjölander
- Department
of Chemistry, IFM, Linköping University, Linköping 581 83, Sweden
| | | | - Per Westermark
- Department
of Immunology, Genetics and Pathology, Uppsala University, Uppsala SE-75123, Sweden
| | - Lars Nilsson
- Department
of Pharmacology, University of Oslo, Oslo 0316, Norway
| | - Per Hammarström
- Department
of Chemistry, IFM, Linköping University, Linköping 581 83, Sweden
| | - K. Peter R. Nilsson
- Department
of Chemistry, IFM, Linköping University, Linköping 581 83, Sweden
| | - Gunnar Antoni
- Preclinical
PET Platform, Department of Medicinal Chemistry, Uppsala University, Uppsala SE-75123, Sweden
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Wang HF, Tan L, Cao L, Zhu XC, Jiang T, Tan MS, Liu Y, Wang C, Tsai RM, Jia JP, Yu JT. Application of the IWG-2 Diagnostic Criteria for Alzheimer’s Disease to the ADNI. J Alzheimers Dis 2016; 51:227-36. [PMID: 26836176 DOI: 10.3233/jad-150824] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hui-Fu Wang
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, China
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China
| | - Lei Cao
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, China
| | - Xi-Chen Zhu
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, China
| | - Teng Jiang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, China
| | - Meng-Shan Tan
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China
| | - Ying Liu
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China
| | - Chong Wang
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China
| | - Richard M. Tsai
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Jian-Ping Jia
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Jin-Tai Yu
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, China
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
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Heurling K, Leuzy A, Zimmer ER, Lubberink M, Nordberg A. Imaging β-amyloid using [18F]flutemetamol positron emission tomography: from dosimetry to clinical diagnosis. Eur J Nucl Med Mol Imaging 2015; 43:362-373. [DOI: 10.1007/s00259-015-3208-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/28/2015] [Indexed: 12/14/2022]
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Akamatsu G, Ikari Y, Nishio T, Nishida H, Ohnishi A, Aita K, Sasaki M, Sasaki M, Senda M. Optimization of image reconstruction conditions with phantoms for brain FDG and amyloid PET imaging. Ann Nucl Med 2015; 30:18-28. [DOI: 10.1007/s12149-015-1024-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 08/26/2015] [Indexed: 11/30/2022]
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Arbizu J, García-Ribas G, Carrió I, Garrastachu P, Martínez-Lage P, Molinuevo JL. Recommendations for the use of PET imaging biomarkers in the diagnosis of neurodegenerative conditions associated with dementia: consensus proposal from the SEMNIM and SEN. Rev Esp Med Nucl Imagen Mol 2015. [DOI: 10.1016/j.remnie.2015.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Arbizu J, García-Ribas G, Carrió I, Garrastachu P, Martínez-Lage P, Molinuevo JL. Recommendations for the use of PET imaging biomarkers in the diagnosis of neurodegenerative conditions associated with dementia: SEMNIM and SEN consensus. Rev Esp Med Nucl Imagen Mol 2015; 34:303-13. [PMID: 26099942 DOI: 10.1016/j.remn.2015.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
Abstract
The new diagnostic criteria for Alzheimer's disease (AD) acknowledges the interest given to biomarkers to improve the specificity in subjects with dementia and to facilitate an early diagnosis of the pathophysiological process of AD in the prodromal or pre-dementia stage. The current availability of PET imaging biomarkers of synaptic dysfunction (PET-FDG) and beta amyloid deposition using amyloid-PET provides clinicians with the opportunity to apply the new criteria and improve diagnostic accuracy in their clinical practice. Therefore, it seems essential for the scientific societies involved to use the new clinical diagnostic support tools to establish clear, evidence-based and agreed set of recommendations for their appropriate use. The present work includes a systematic review of the literature on the utility of FDG-PET and amyloid-PET for the diagnosis of AD and related neurodegenerative diseases that occur with dementia. Thus, we propose a series of recommendations agreed on by the Spanish Society of Nuclear Medicine and Spanish Society of Neurology as a consensus statement on the appropriate use of PET imaging biomarkers.
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Affiliation(s)
- Javier Arbizu
- Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, España.
| | | | - Ignasi Carrió
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Puy Garrastachu
- Servicio de Medicina Nuclear, Hospital San Pedro y Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, España
| | - Pablo Martínez-Lage
- Neurología Fundación CITA-Alzhéimer Fundazioa, Centro de Investigación y Terapias Avanzadas, San Sebastián, España
| | - José Luis Molinuevo
- Unidad de Enfermedad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clinic i Universitari ICN y Fundación Pasqual Maragall, Barcelona, España
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Abstract
The recent development and introduction of new hybrid imaging devices combining positron emission tomography (PET) technology with magnetic resonance imaging (MRI) opens up new perspectives in clinical molecular imaging. Combining MRI and fluorine-18 choline PET would theoretically produce valuable clinical data in a single imaging session, which can be used for staging, prognosis, and assessment of treatment response. Fluorine-18-sodium fluoride (18F-NaF) is a highly sensitive PET tracer used as a marker of osteoblastic abnormalities. PET imaging with (68)Ga-DOTATATE or DOTATOC has demonstrated promising results for locating metastatic lesions, occasionally with superior sensitivity than whole-body MRI. l-DOPA PET adds data regarding l-DOPA metabolism, which may increase the specificity and sensibility of the study itself. Fluoromisonidazole is known to be not only a useful tracer for determining hypoxic cells but also an efficient hypoxic radiosensitizer.
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Affiliation(s)
- Miguel Hernandez Pampaloni
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Avenue, M-396, San Francisco, CA 94143, USA.
| | - Lorenzo Nardo
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Avenue, M-396, San Francisco, CA 94143, USA; Department of Radiology, Brescia, Italy
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25
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Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disorder affecting the elderly. Current clinical diagnostic tools are often ineffective in accurately diagnosing AD. However, new advances in diagnostic imaging, particularly positron emission tomography (PET) amyloid imaging, have shown increased sensitivity and specificity, as well as high inter-reader agreement. The most commonly studied tracer, PiB-C11, has shown high affinity binding to amyloid, but is limited in its use outside of research due to its short half-life. Instead, development of other PET ligands with increased half-life, such as fluorine-18-labeled ((18)F) tracers, allows for more widespread use of PET in clinical settings. In particular, recent phase II and III trials of (18)F-florbetaben have demonstrated the high accuracy of this PET tracer in identifying amyloid accumulation. This paper will examine the techniques of amyloid imaging, focusing particularly on the recently approved (18)F-florbetaben.
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Affiliation(s)
- Danielle Richards
- The Cleo Roberts Center for Clinical Research, Banner Sun Health Research Institute, 10515 West Santa Fe Drive, Sun City, AZ 85351 USA
| | - Marwan N. Sabbagh
- The Cleo Roberts Center for Clinical Research, Banner Sun Health Research Institute, 10515 West Santa Fe Drive, Sun City, AZ 85351 USA
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26
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Affiliation(s)
- A H V Schapira
- Department of Clinical Neurosciences, UCL Institute of Neurology, London, UK.
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The influence of polysorbate 80 on the radiochemical synthesis of a PET tracer in the FASTlab. Pharm Res 2014; 32:1425-37. [PMID: 25366546 DOI: 10.1007/s11095-014-1547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of current study was to investigate the influence of a common non-ionic surfactant, polysorbate 80 (PS80), on radioactive labelling process of a novel PET tracer, [(18)F]Flutemetamol. METHODS Ferrous oxidation-xylenol orange (FOX) assay, in addition to UV/VIS and (1)H NMR spectroscopies were applied to characterise the composition of the PS80 solution after storage. Multivariate Curve Resolution (MCR) and PLS analysis was used to establish correlation between quality of the PS80 solution and the RCP obtained after labelling. RESULTS The levels of unsaturated fatty acid moieties of PS80 were negatively correlated to RCP of [(18)F]Flutemetamol after synthesis. This explains the slight increase in RCP when stored PS80 solutions were applied in the synthesis. The mechanism behind this observation is suggested to be related to radiation induced radical formation in the unsaturated fatty acids, which subsequently causes instability of the PET tracer. UV/VIS spectroscopy was demonstrated to have the ability as a possible control tool for quality assurance of the studied radioactive labelling process. CONCLUSIONS The presence of unsaturated fatty acid moieties in PS80 was found to be one of the most important factors responsible for the reduction in RCP of [(18)F]Flutemetamol after synthesis.
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Idiopathic normal pressure hydrocephalus: cerebral perfusion measured with pCASL before and repeatedly after CSF removal. J Cereb Blood Flow Metab 2014; 34:1771-8. [PMID: 25138210 PMCID: PMC4269752 DOI: 10.1038/jcbfm.2014.138] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/30/2014] [Accepted: 07/02/2014] [Indexed: 11/08/2022]
Abstract
Pseudo-continuous arterial spin labeling (pCASL) measurements were performed in 20 patients with idiopathic normal pressure hydrocephalus (iNPH) to investigate whether cerebral blood flow (CBF) increases during the first 24 hours after a cerebrospinal fluid tap test (CSF TT). Five pCASL magnetic resonance imaging (MRI) scans were performed. Two scans were performed before removal of 40 mL CSF, and the other three at 30 minutes, 4 hours, and 24 hours, respectively after the CSF TT. Thirteen different regions of interest (ROIs) were manually drawn on coregistered MR images. In patients with increased CBF in lateral and frontal white matter after the CSF TT, gait function improved more than it did in patients with decreased CBF in these regions. However, in the whole sample, there was no significant increase in CBF after CSF removal compared with baseline investigations. The repeatability of CBF measurements at baseline was high, with intraclass correlation coefficients of 0.60 to 0.90 for different ROIs, but the median regional variability was in the range of 5% to 17%. Our results indicate that CBF in white matter close to the lateral ventricles plays a role in the reversibility of symptoms after CSF removal in patients with iNPH.
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29
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Snellman A, Rokka J, López-Picón FR, Eskola O, Salmona M, Forloni G, Scheinin M, Solin O, Rinne JO, Haaparanta-Solin M. In vivo PET imaging of beta-amyloid deposition in mouse models of Alzheimer's disease with a high specific activity PET imaging agent [(18)F]flutemetamol. EJNMMI Res 2014; 4:37. [PMID: 25977876 PMCID: PMC4412375 DOI: 10.1186/s13550-014-0037-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/02/2014] [Indexed: 01/07/2023] Open
Abstract
Background The purpose of the study was to evaluate the applicability of 18F-labelled amyloid imaging positron emission tomography (PET) agent [18F]flutemetamol to detect changes in brain beta-amyloid (Aβ) deposition in vivo in APP23, Tg2576 and APPswe-PS1dE9 mouse models of Alzheimer's disease. We expected that the high specific activity of [18F]flutemetamol would make it an attractive small animal Aβ imaging agent. Methods [18F]flutemetamol uptake in the mouse brain was evaluated in vivo at 9 to 22 months of age with an Inveon Multimodality PET/CT camera (Siemens Medical Solutions USA, Knoxville, TN, USA). Retention in the frontal cortex (FC) was evaluated by Logan distribution volume ratios (DVR) and FC/cerebellum (CB) ratios during the late washout phase (50 to 60 min). [18F]flutemetamol binding to Aβ was also evaluated in brain slices by in vitro and ex vivo autoradiography. The amount of Aβ in the brain slices was determined with Thioflavin S and anti-Aβ1−40 immunohistochemistry. Results In APP23 mice, [18F]flutemetamol retention in the FC increased from 9 to 18 months. In younger mice, DVR and FC/CB50-60 were 0.88 (0.81) and 0.88 (0.89) at 9 months (N = 2), and 0.98 (0.93) at 12 months (N = 1), respectively. In older mice, DVR and FC/CB50-60 were 1.16 (1.15) at 15 months (N = 1), 1.13 (1.16) and 1.35 (1.35) at 18 months (N = 2), and 1.05 (1.31) at 21 months (N = 1). In Tg2576 mice, DVR and FC/CB50-60 showed modest increasing trends but also high variability. In APPswe-PS1dE9 mice, DVR and FC/CB50-60 did not increase with age. Thioflavin S and anti-Aβ1−40 positive Aβ deposits were present in all transgenic mice at 19 to 22 months, and they co-localized with [18F]flutemetamol binding in the brain slices examined with in vitro and ex vivo autoradiography. Conclusions Increased [18F]flutemetamol retention in the brain was detected in old APP23 mice in vivo. However, the high specific activity of [18F]flutemetamol did not provide a notable advantage in Tg2576 and APPswe-PS1dE9 mice compared to the previously evaluated structural analogue [11C]PIB. For its practical benefits, [18F]flutemetamol imaging with a suitable mouse model like APP23 is an attractive alternative.
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Affiliation(s)
- Anniina Snellman
- Medicity/PET Preclinical Laboratory, Turku PET Centre, University of Turku, Tykistökatu 6 A, Turku 20520, Finland
| | - Johanna Rokka
- Radiopharmaceutical Chemistry Laboratory, Turku PET Centre, University of Turku, Porthaninkatu 3, Turku 20500, Finland
| | - Francisco R López-Picón
- Medicity/PET Preclinical Laboratory, Turku PET Centre, University of Turku, Tykistökatu 6 A, Turku 20520, Finland
| | - Olli Eskola
- Radiopharmaceutical Chemistry Laboratory, Turku PET Centre, University of Turku, Porthaninkatu 3, Turku 20500, Finland
| | - Mario Salmona
- Mario Negri Institute for Pharmacological Research, Milan 20156, Italy
| | - Gianluigi Forloni
- Mario Negri Institute for Pharmacological Research, Milan 20156, Italy
| | - Mika Scheinin
- Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Kiinamyllynkatu 10, Turku 20520, Finland ; Unit of Clinical Pharmacology, TYKSLAB, Turku University Hospital, Kiinamyllynkatu 10, Turku 20520, Finland
| | - Olof Solin
- Radiopharmaceutical Chemistry Laboratory, Turku PET Centre, University of Turku, Porthaninkatu 3, Turku 20500, Finland
| | - Juha O Rinne
- Turku PET Centre, University of Turku, Turku 20521, Finland
| | - Merja Haaparanta-Solin
- Medicity/PET Preclinical Laboratory, Turku PET Centre, University of Turku, Tykistökatu 6 A, Turku 20520, Finland
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Dubois B, Feldman HH, Jacova C, Hampel H, Molinuevo JL, Blennow K, DeKosky ST, Gauthier S, Selkoe D, Bateman R, Cappa S, Crutch S, Engelborghs S, Frisoni GB, Fox NC, Galasko D, Habert MO, Jicha GA, Nordberg A, Pasquier F, Rabinovici G, Robert P, Rowe C, Salloway S, Sarazin M, Epelbaum S, de Souza LC, Vellas B, Visser PJ, Schneider L, Stern Y, Scheltens P, Cummings JL. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. Lancet Neurol 2014; 13:614-29. [PMID: 24849862 DOI: 10.1016/s1474-4422(14)70090-0] [Citation(s) in RCA: 2227] [Impact Index Per Article: 222.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD.
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Affiliation(s)
- Bruno Dubois
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France.
| | - Howard H Feldman
- Division of Neurology, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
| | - Claudia Jacova
- UBC Division of Neurology, S152 UBC Hospital, BC, Canada
| | - Harald Hampel
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, IDIBAPS Hospital Clinici Universitari, Barcelona, Spain; BarcelonaBeta Brain Research Centre, Fundació Pasqual Maragall, Barcelona, Spain
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Steven T DeKosky
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Serge Gauthier
- McGill Center for Studies in Aging, Douglas Hospital, Montreal, Quebec, QC, Canada
| | - Dennis Selkoe
- Harvard Medical School Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Randall Bateman
- Washington University School of Medicine, St Louis, Missouri, MO, USA
| | - Stefano Cappa
- Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, Cognitive Neurorehabilitation, Milan, Italy
| | - Sebastian Crutch
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK; Dementia Research Centre, National Hospital, London, UK
| | - Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA), Middelheim and Hoge Beuken, Antwerp, Belgium; Reference Centre for Biological Markers of Dementia, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Giovanni B Frisoni
- Hopitaux Universitaires et Université de Genève, Geneva, Switzerland; IRCCS Fatebenefratelli, Brescia, Italy; HUG Belle-Idée, bâtiment les Voirons, Chêne-Bourg, France
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK
| | - Douglas Galasko
- Department of Neurosciences, -University of California, San Diego, CA, USA
| | - Marie-Odile Habert
- INSERM UMR, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Nucléaire, Paris, France
| | - Gregory A Jicha
- University of Kentucky Alzheimer's Disease Center, Lexington, KY, USA
| | - Agneta Nordberg
- Karolinska Institutet, Karolinska University Hospital Huddinge, Alzheimer Neurobiology Center, Stockholm, Sweden
| | - Florence Pasquier
- Université Lille Nord de France, Lille, France; CHRU, Clinique Neurologique, Hôpital Roger Salengro, Lille, France
| | - Gil Rabinovici
- UCSF Memory & Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Philippe Robert
- EA CoBTeK and Memory Center, CHU University of Nice, UNSA, Hôpital de Cimiez 4 av Victoria, Nice, France
| | - Christopher Rowe
- FRACP, Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Melbourne, VIC, Australia
| | - Stephen Salloway
- Neurology and the Memory and Aging Program, Butler Hospital, Department of Neurology and Psychiatry, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Paris Cedex, France; Université Paris 5, Paris, France
| | - Stéphane Epelbaum
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - Leonardo C de Souza
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France; Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Bruno Vellas
- Gerontopole, Pavillon Junod, University Toulouse 3, Toulouse, France
| | - Pieter J Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands; Department of Neurology and Alzheimer Center, Amsterdam, Netherlands
| | - Lon Schneider
- Department of Psychiatry, Neurology, and Gerontology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division of the Taub Institute, Presbyterian Hospital, New York, NY, USA
| | - Philip Scheltens
- Alzheimer Centrum Vrije Universiteit Medical Center, VU University, Amsterdam, Netherlands
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Leinonen V, Rinne JO, Wong DF, Wolk DA, Trojanowski JQ, Sherwin PF, Smith A, Heurling K, Su M, Grachev ID. Diagnostic effectiveness of quantitative [¹⁸F]flutemetamol PET imaging for detection of fibrillar amyloid β using cortical biopsy histopathology as the standard of truth in subjects with idiopathic normal pressure hydrocephalus. Acta Neuropathol Commun 2014; 2:46. [PMID: 24755237 PMCID: PMC4003513 DOI: 10.1186/2051-5960-2-46] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 04/10/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION PET imaging of amyloid-β (Aβ) in vivo holds promise for aiding in earlier diagnosis and intervention in Alzheimer's disease (AD) and mild cognitive impairment. AD-like Aβ pathology is a common comorbidity in patients with idiopathic normal pressure hydrocephalus (iNPH). Fifty patients with iNPH needing ventriculo-peritoneal shunting or intracranial pressure monitoring underwent [18F]flutemetamol PET before (N = 28) or after (N = 22) surgery. Cortical uptake of [18F]flutemetamol was assessed visually by blinded reviewers, and also quantitatively via standard uptake value ratio (SUVR) in specific neocortical regions in relation to either cerebellum or pons reference region: the cerebral cortex of (prospective studies) or surrounding (retrospective studies) the biopsy site, the contralateral homolog, and a calculated composite brain measure. Aβ pathology in the biopsy specimen (standard of truth [SoT]) was measured using Bielschowsky silver and thioflavin S plaque scores, percentage area of grey matter positive for monoclonal antibody to Aβ (4G8), and overall pathology impression. We set out to find (1) which pair(s) of PET SUVR and pathology SoT endpoints matched best, (2) whether quantitative measures of [18F]flutemetamol PET were better for predicting the pathology outcome than blinded image examination (BIE), and (3) whether there was a better match between PET image findings in retrospective vs. prospective studies. RESULTS Of the 24 possible endpoint/SoT combinations, the one with composite-cerebellum SUVR and SoT based on overall pathology had the highest Youden index (1.000), receiver operating characteristic area under the curve (1.000), sensitivity (1.000), specificity (1.000), and sum of sensitivity and specificity for the pooled data as well as for the retrospective and prospective studies separately (2.00, for all 3). The BIE sum of sensitivity and specificity, comparable to that for quantitation, was highest using Bielschowsky silver as SoT for all SUVRs (ipsilateral, contralateral, and composite, for both reference regions). The composite SUVR had a 100% positive predictive value (both reference regions) for the overall pathology diagnosis. All SUVRs had a 100% negative predictive value for the Bielschowsky silver result. CONCLUSION Bielschowsky silver stain and overall pathology judgment showed the strongest associations with imaging results.
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Affiliation(s)
- Ville Leinonen
- Department of Neurosurgery, Kuopio University Hospital NeuroCenter and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juha O Rinne
- Turku PET Centre and Department of Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Dean F Wong
- The Russell H. Morgan Department of Radiology and Radiological Science, Psychiatry and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David A Wolk
- Department of Neurology, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology, Penn Memory Center, Institute on Aging, and Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - Mandy Su
- Biostatistics, H2O Clinical, Hunt Valley, MD, USA
| | - Igor D Grachev
- Life Sciences, GE Healthcare, 101 Carnegie Center, Princeton, NJ 08540, USA
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Murugan NA, Zaleśny R, Kongsted J, Nordberg A, Ågren H. Promising two-photon probes for in vivo detection of β amyloid deposits. Chem Commun (Camb) 2014; 50:11694-7. [DOI: 10.1039/c4cc03897e] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A novel relationship between the charge-transfer descriptor, Δr, and two-photon absorption cross-sections in NIRF probes.
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Affiliation(s)
- N. Arul Murugan
- Division of Theoretical Chemistry and Biology
- School of Biotechnology
- Royal Institute of Technology
- SE-10691 Stockholm, Sweden
| | - Robert Zaleśny
- Division of Theoretical Chemistry and Biology
- School of Biotechnology
- Royal Institute of Technology
- SE-10691 Stockholm, Sweden
- Institute of Physical and Theoretical Chemistry
| | - Jacob Kongsted
- Department of Physics
- Chemistry and Pharmacy
- University of Southern Denmark
- DK-5230 Odense M, Denmark
| | - Agneta Nordberg
- Karolinska Institutet
- Dept NVS
- Center for Alzheimer Research
- Translational Alzheimer Neurobiology
- Novum, Sweden
| | - Hans Ågren
- Division of Theoretical Chemistry and Biology
- School of Biotechnology
- Royal Institute of Technology
- SE-10691 Stockholm, Sweden
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Cerebral amyloid PET imaging in Alzheimer's disease. Acta Neuropathol 2013; 126:643-57. [PMID: 24100688 DOI: 10.1007/s00401-013-1185-7] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/24/2013] [Accepted: 09/25/2013] [Indexed: 12/14/2022]
Abstract
The devastating effects of the still incurable Alzheimer's disease (AD) project an ever increasing shadow of burden on the health care system and society in general. In this ominous context, amyloid (Aβ) imaging is considered by many of utmost importance for progress towards earlier AD diagnosis and for potential development of effective therapeutic interventions. Amyloid imaging positron emission tomography procedures offer the opportunity for accurate mapping and quantification of amyloid-Aβ neuroaggregate deposition in the living brain of AD patients. This review analyzes the perceived value of current Aβ imaging probes and their clinical utilization and, based on amyloid imaging results, offers a hypothesis on the effects of amyloid deposition on the biology of AD and its progression. It also analyzes lingering questions permeating the field of amyloid imaging on the apparent contradictions between imaging results and known neuropathology brain regional deposition of Aβ aggregates. As a result, the review also discusses literature evidence as to whether brain Aβ deposition is truly visualized and measured with these amyloid imaging agents, which would have significant implications in the understanding of the biological AD cascade and in the monitoring of therapeutic interventions with these surrogate Aβ markers.
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Amyloid PET in clinical practice: Its place in the multidimensional space of Alzheimer's disease. NEUROIMAGE-CLINICAL 2013; 2:497-511. [PMID: 24179802 PMCID: PMC3777773 DOI: 10.1016/j.nicl.2013.03.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/19/2013] [Accepted: 03/21/2013] [Indexed: 01/18/2023]
Abstract
Amyloid imaging is currently introduced to the market for clinical use. We will review the evidence demonstrating that the different amyloid PET ligands that are currently available are valid biomarkers for Alzheimer-related β amyloidosis. Based on recent findings from cross-sectional and longitudinal imaging studies using different modalities, we will incorporate amyloid imaging into a multidimensional model of Alzheimer's disease. Aside from the critical role in improving clinical trial design for amyloid-lowering drugs, we will also propose a tentative algorithm for when it may be useful in a memory clinic environment. Gaps in our evidence-based knowledge of the added value of amyloid imaging in a clinical context will be identified and will need to be addressed by dedicated studies of clinical utility.
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