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21.03.2019 | Original Article

¹²³I-FP-CIT striatal binding ratios do not decrease significantly with age in older adults

verfasst von: Gemma Roberts, James J. Lloyd, George S. Petrides, Paul C. Donaghy, Joseph P. M. Kane, Rory Durcan, Sarah Lawley, Kim Howe, Andrew J. Sims, John-Paul Taylor, John T. O’Brien, Alan J. Thomas

Erschienen in: Annals of Nuclear Medicine | Ausgabe 6/2019

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Abstract

Objective

I-123-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)nortropane (FP-CIT) imaging is an established biomarker used in the diagnosis of Lewy body disease. Images are often reported with the aid of striatal binding ratios (SBRs), comparing uptake to a normal database via Z scores. It is well known that SBRs are age dependent. However, previous studies cover wide age ranges between 20 and 80 years, rather than focusing on older adults. Typically a linear relationship is reported, but some authors have suggested that SBRs do not decline as rapidly in old age. Commercial software packages usually adjust the SBR Z score to attempt to compensate for age-related decline, but the model used varies. Ensuring age correction is appropriate for older adults is important, given that the majority of patients referred for FP-CIT scans are aged over 60 years. We examined the relationship of SBR with age in older adults and the effect of age correction using research scans from 123 adults over 60 years of age.

Methods

Twenty-nine healthy older adults and twenty-three with MCI due to Alzheimer’s disease were included as controls, i.e. individuals with no evidence of Lewy body disease. Their ages ranged from 60 to 92 years (mean 76; SD 7.9). SBRs and Z scores were calculated using BRASS (Hermes Medical) and DaTQUANT (GE Healthcare). SBRs were plotted against age and linear mixed effect models applied. We tested the effect of removing age correction in BRASS using an independent dataset of 71 older adults with dementia or mild cognitive impairment.

Results

The slopes of the linear fits between SBR and age per year were − 0.007 (p = 0.30) with BRASS and − 0.004 (p = 0.35) with DaTQUANT. The slopes are smaller than reported in the literature and show no statistically significant difference from zero. Switching age correction off in BRASS in the test subjects reduced Z scores by approximately 1 standard deviation at 80 years of age.

Conclusion

We found no statistically significant age-related decline in SBR in adults over 60 years of age without Lewy body disease. Commercial software packages that apply a fixed rate of age correction may be overcorrecting for age in older adults, which could contribute to misdiagnosis.

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Titel: 123I-FP-CIT striatal binding ratios do not decrease significantly with age in older adults
verfasst von: Gemma Roberts
James J. Lloyd
George S. Petrides
Paul C. Donaghy
Joseph P. M. Kane
Rory Durcan
Sarah Lawley
Kim Howe
Andrew J. Sims
John-Paul Taylor
John T. O’Brien
Alan J. Thomas
Publikationsdatum: 21.03.2019
Verlag: Springer Singapore
Erschienen in: Annals of Nuclear Medicine / Ausgabe 6/2019
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-019-01352-x

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

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