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26.04.2023 | Neuro

Feasibility of ¹⁸F-florzolotau quantification in patients with Alzheimer’s disease based on an MRI-free tau PET template

verfasst von: Jiaying Lu, Zizhao Ju, Min Wang, Xun Sun, Chenhao Jia, Ling Li, Weiqi Bao, Huiwei Zhang, Fangyang Jiao, Huamei Lin, Tzu-Chen Yen, Ruixue Cui, Xiaoli Lan, Qianhua Zhao, Yihui Guan, Chuantao Zuo, for the Shanghai Memory Study (SMS)

Erschienen in: European Radiology | Ausgabe 7/2023

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Abstract

Objectives

Quantification of tau accumulation using positron emission tomography (PET) is critical for the diagnosis of Alzheimer’s disease (AD). This study aimed to evaluate the feasibility of ¹⁸F-florzolotau quantification in patients with AD using a magnetic resonance imaging (MRI)–free tau PET template, since individual high-resolution MRI is costly and not always available in practice.

Methods

¹⁸F-florzolotau PET and MRI scans were obtained in a discovery cohort including (1) patients within the AD continuum (n = 87), (2) cognitively impaired patients with non-AD (n = 32), and (3) cognitively unimpaired subjects (n = 26). The validation cohort comprised 24 patients with AD. Following MRI-dependent spatial normalization (standard approach) in randomly selected subjects (n = 40) to cover the entire spectrum of cognitive function, selected PET images were averaged to create the ¹⁸F-florzolotau-specific template. Standardized uptake value ratios (SUVRs) were calculated in five predefined regions of interest (ROIs). MRI-free and MRI-dependent methods were compared in terms of continuous and dichotomous agreement, diagnostic performances, and associations with specific cognitive domains.

Results

MRI-free SUVRs had a high continuous and dichotomous agreement with MRI-dependent measures for all ROIs (intraclass correlation coefficient ≥ 0.980; agreement ≥ 94.5%). Similar findings were observed for AD-related effect sizes, diagnostic performances with respect to categorization across the cognitive spectrum, and associations with cognitive domains. The robustness of the MRI-free approach was confirmed in the validation cohort.

Conclusions

The use of an ¹⁸F-florzolotau-specific template is a valid alternative to MRI-dependent spatial normalization, improving the clinical generalizability of this second-generation tau tracer.

Key Points

• Regional ¹⁸F-florzolotau SUVRs reflecting tau accumulation in the living brains are reliable biomarkers for the diagnosis, differential diagnosis, and assessment of disease severity in patients with AD.

• The ¹⁸F-florzolotau-specific template is a valid alternative to MRI-dependent spatial normalization, improving the clinical generalizability of this second-generation tau tracer.

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Titel: Feasibility of 18F-florzolotau quantification in patients with Alzheimer’s disease based on an MRI-free tau PET template
verfasst von: Jiaying Lu
Zizhao Ju
Min Wang
Xun Sun
Chenhao Jia
Ling Li
Weiqi Bao
Huiwei Zhang
Fangyang Jiao
Huamei Lin
Tzu-Chen Yen
Ruixue Cui
Xiaoli Lan
Qianhua Zhao
Yihui Guan
Chuantao Zuo
for the Shanghai Memory Study (SMS)
Publikationsdatum: 26.04.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 7/2023
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09571-7

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Feasibility of ¹⁸F-florzolotau quantification in patients with Alzheimer’s disease based on an MRI-free tau PET template