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Detection of Alzheimer Pathology In Vivo Using Both ¹¹C-PIB and ¹⁸F-FDDNP PET

¹ Department of Nuclear Medicine and PET Research, VU University Medical Centre, Amsterdam, The Netherlands; ² Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands; and ³ Department of Radiology, VU University Medical Centre, Amsterdam, The Netherlands

Correspondence: For correspondence or reprints contact: Nelleke Tolboom, Department of Neurology and Alzheimer Centre, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. E-mail: n.tolboom{at}vumc.nl

¹¹C-Pittsburgh Compound-B (¹¹C-PIB) and ¹⁸F-(2-(1-{6-[(2-[¹⁸F]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene) (¹⁸F-FDDNP) have been developed as PET tracers for in vivo imaging of pathology in Alzheimer's disease (AD). The purpose of this study was to directly compare these tracers in patients with AD, patients with mild cognitive impairment (MCI), and healthy controls. Methods: Paired ¹¹C-PIB and ¹⁸F-FDDNP scans were acquired in 14 patients with AD, 11 patients with amnestic MCI, and 13 controls. For both tracers, parametric images of binding potential (BP_ND) were generated. Global cortical BP_ND was assessed using ANOVA. In addition, regional patterns of BP_ND were compared between diagnostic groups using ANOVA for repeated measures. Results: Global cortical BP_ND of ¹¹C-PIB showed higher binding in patients with AD than in controls and patients with MCI. ¹⁸F-FDDNP uptake was higher in patients with AD than in controls, but MCI could not be distinguished from AD or from controls. Global BP_ND values of both tracers were moderately correlated (r = 0.45; P = 0.005). In MCI, BP_ND of ¹¹C-PIB showed a bimodal distribution, whereas values for ¹⁸F-FDDNP were more widespread, with more MCI patients demonstrating increased uptake. Regional ¹¹C-PIB binding showed different patterns across diagnostic groups, as AD patients showed an overall increase in binding, with the lowest binding in the medial temporal lobe. With ¹⁸F-FDDNP, patterns were similar across diagnostic groups. For all groups, highest values were observed in the medial temporal lobe. Conclusion: Differences in BP_ND between patients with AD, patients with MCI, and controls were more pronounced for ¹¹C-PIB. The difference in regional binding, the moderate correlation, and the discrepant findings in MCI suggest that they measure related, but different, characteristics of the disease.

Key Words: ¹¹C-PIB • Pittsburgh Compound-B • ¹⁸F-FDDNP • positron emission tomography • PET • amyloid • Alzheimer disease

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.

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