Dual-phase 18F-florbetapir positron emission tomography in patients with primary progressive aphasia, Alzheimer's disease, and healthy controls: A preliminary study

Hung-Chou Kuo; Ing-Tsung Hsiao; Chia-Ju Hsieh; Chu-Yun Huang; Kuo-Lun Huang; Yau-Yau Wai; Wen-Li Chuang; Mei-Ping Kung; Yi-Chuan Chu; Tzu-Chen Yen; Kun-Ju Lin; Chin-Chang Huang

Journal of the Formosan Medical Association (Dec 2017)

Dual-phase 18F-florbetapir positron emission tomography in patients with primary progressive aphasia, Alzheimer's disease, and healthy controls: A preliminary study

Hung-Chou Kuo,
Ing-Tsung Hsiao,
Chia-Ju Hsieh,
Chu-Yun Huang,
Kuo-Lun Huang,
Yau-Yau Wai,
Wen-Li Chuang,
Mei-Ping Kung,
Yi-Chuan Chu,
Tzu-Chen Yen,
Kun-Ju Lin,
Chin-Chang Huang

Affiliations

Hung-Chou Kuo: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
Ing-Tsung Hsiao: Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
Chia-Ju Hsieh: Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
Chu-Yun Huang: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan; College of Pharmacy, Taipei Medical University, Taipei, Taiwan
Kuo-Lun Huang: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
Yau-Yau Wai: Department of Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Wen-Li Chuang: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
Mei-Ping Kung: Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Radiology, University of Pennsylvania, PA, USA
Yi-Chuan Chu: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
Tzu-Chen Yen: Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
Kun-Ju Lin: Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
Chin-Chang Huang: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan; Corresponding author. Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Number 5, Fuxing Street, Guishan Township, Taoyuan County 333, Taiwan.

Journal volume & issue: Vol. 116, no. 12
pp. 964 – 972

Abstract

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Background/Purpose: To determine whether dual-phase 18F-florbetapir positron emission tomography imaging with perfusion-like and amyloid deposition information can distinguish among primary progressive aphasia (PPA), Alzheimer's disease (AD), and healthy controls (HCs). Methods: Patients diagnosed with PPA, including four semantic dementia (SD) and two progressive nonfluent aphasia (PNFA), as well as one logopenic variant (LV) of PPA, were studied. All PPA patients, and age-/sex-matched patients with probable AD (n=8) and HCs (n=8) were subjected to dual-phase 18F-florbetapir imaging. Atlas-based quantitative volumes of interest (VOIs) analysis for six cortical areas and whole cerebellum was performed. The standardized uptake value ratios were calculated by normalizing the dual-phase-integrated activities of the six VOIs to whole cerebellum counts. Results: Early phase 18F-florbetapir image showed significantly lower global perfusion index in six PPA patients as compared with HCs. According to VOI analysis, the hypoperfusion lesions were identified in the frontal, anterior cingulate, parietal, precuneus, and temporal regions. Similar findings were confirmed by voxel-base image comparison. 18F-florbetapir late-phase image showed significantly increased amyloid burden in the global cortex index and all six brain regions of eight AD and LV patients when compared with the other six PPA patients and eight HCs. There was no apparent uptake of amyloid tracer in both six PPA patients and eight HCs. Conclusion: Dual-phase 18F-florbetapir images of six PPA (SD and PNFA) patients showed hypoperfusion in the frontotemporal cortex, and little global amyloid uptake, which may be a distinct image pattern for differentiation among HC, AD, and PPA patients. Keywords: 18F-florbetapir (AV-45/Amyvid amyloid imaging), Alzheimer's disease, logopenic variant, primary progressive aphasia, progressive nonfluent aphasia, semantic dementia, dementia, clinical neurology, diagnostic imaging, radiology, nuclear medicine and medical imaging

Published in Journal of the Formosan Medical Association

ISSN: 0929-6646 (Print)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General)
Website: http://www.journals.elsevier.com/journal-of-the-formosan-medical-association/

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