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Research ArticleClinical Investigations

Amyloid-β Imaging with Pittsburgh Compound B and Florbetapir: Comparing Radiotracers and Quantification Methods

Susan M. Landau, Christopher Breault, Abhinay D. Joshi, Michael Pontecorvo, Chester A. Mathis, William J. Jagust and Mark A. Mintun
Journal of Nuclear Medicine January 2013, 54 (1) 70-77; DOI: https://doi.org/10.2967/jnumed.112.109009
Susan M. Landau
1Helen Wills Neuroscience Institute, University of California, Berkeley, California
2Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California
3Avid Radiopharmaceuticals, Inc., Philadelphia, Pennsylvania
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Christopher Breault
3Avid Radiopharmaceuticals, Inc., Philadelphia, Pennsylvania
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Abhinay D. Joshi
3Avid Radiopharmaceuticals, Inc., Philadelphia, Pennsylvania
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Michael Pontecorvo
3Avid Radiopharmaceuticals, Inc., Philadelphia, Pennsylvania
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Chester A. Mathis
4Department of Radiology, PET Facility, University of Pittsburgh, Pittsburgh, Pennsylvania; and
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William J. Jagust
1Helen Wills Neuroscience Institute, University of California, Berkeley, California
2Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California
5School of Public Health, University of California, Berkeley, California
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Mark A. Mintun
3Avid Radiopharmaceuticals, Inc., Philadelphia, Pennsylvania
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  • FIGURE 1.
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    FIGURE 1.

    Axial slices of PiB and florbetapir scans are shown for 2 representative subjects, cognitively normal control with low tracer retention (top) and AD patient with high tracer retention in cortex relative to cerebellum, reflecting widespread fibrillar amyloid (bottom).

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    FIGURE 2.

    Cortical retention ratios are shown for consecutive PiB and florbetapir scans obtained for same participants and processed using pons (A), whole cerebellum (B), and cerebellar gray matter (C) for intensity normalization. Initial diagnosis at enrollment and any subsequent diagnostic change are represented by shape markers. Stable normal cognition or MCI diagnosis is represented with solid shapes, individuals who progressed are represented with unfilled shapes, and single individual who regressed from MCI to normal is represented with gray-filled square. Raw data were analyzed with PET-template method. Regression equations and Spearman rank correlation coefficients (ρ) are shown for each scatterplot.

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    FIGURE 3.

    Cortical retention ratios for 2 consecutive PiB scans and PiB scan followed by florbetapir scan obtained for same participants are compared at different levels of preprocessing and data analysis methods. All cortical retention ratios were normalized using whole cerebellum. Top 2 rows show raw data (not at uniform voxel size or smoothing) (A) and unsmoothed data (at uniform voxel size but not uniform smoothing) (B), both processed using PET-template method. Bottom 2 rows show unsmoothed (C) and smoothed data (uniform voxel size and smoothing) (D) processed with Freesurfer method. Thus, middle 2 rows both show unsmoothed data that differs only on basis of which processing method was used (PET template [B], Freesurfer [C]). Regression equations and Spearman rank correlation coefficients (ρ) are shown for each scatterplot.

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    FIGURE 4.

    PiB threshold of 1.47 (14) that is based on data normalized to cerebellar gray matter can be converted to florbetapir threshold of 1.13, using raw data and whole-cerebellum normalization.

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    TABLE 1

    Demographic and Descriptive Information for Study Population

    Diagnosis at enrollment
    ParameterTotal sample (n = 32)Normal cognition (n = 8)MCI (n = 24)
    Duration of follow-up (y)4.34.34.3
    Mean age (±SD) at PiB2 scan (y)75.7 ± 6.677.6 ± 3.975.1 ± 7.3
    Mean age (±SD) at florbetapir scan (y)77.3 ± 6.579.3 ± 3.776.7 ± 7.2
    Mean time (±SD) between PiB1 and PiB2 scans (y)1.1 ± 0.31.0 ± 0.081.1 ± 0.3
    Mean time (±SD) between PiB2 and florbetapir scans (y)1.5 ± 0.71.6 ± 0.81.4 ± 0.6
    Sex, female (%)312533
    Mean number of years (±SD) of education16.1 ± 3.015.9 ± 3.016.1 ± 3.0
    Apolipoprotein E4 carriers (%)535054
    Mean MMSE score (±SD) at florbetapir scan25.2 ± 6.028.3 ± 1.724.1 ± (.6
    Mean ADAS-cog score (±SD) at florbetapir scan13.2 ± 12.36.8 ± 4.715.4 ± 13.3
    Mean PiB2 cortical retention1.51 (95% CI, 1.31–1.71)1.34 (95% CI, 0.99–1.68)1.57 (95% CI, 1.31–1.82)
    Mean florbetapir cortical retention1.25 (95% CI, 1.13–1.38)1.13 (95% CI, 0.96–1.30)1.29 (95% CI, 1.13–1.45)
    Diagnosis at PiB2 scan (n)
     Normal cognition651
     MCI22319
     AD404
    Diagnosis at florbetapir scan (n)
     Normal cognition651
     MCI17314
     AD909
    • 95% confidence intervals (95% CIs) are for raw data processed using PET-template method. Subject diagnostic groups are based on diagnosis at enrollment, but changes in diagnosis between enrollment, PiB2, and florbetapir scanning sessions are noted. Summary cognitive scores (mini-mental state examination [MMSE], Alzheimer’s Disease Assessment Scale–cognitive subscale [ADAS-cog]) are given for participants’ most recent imaging session.

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    TABLE 2

    Mean Difference and Percentage Change Between Consecutive Scans Across All Participants

    PiB1 vs. PiB2PiB2 vs. florbetapir
    ParameterPonsWhole cerebellumCerebellar grayPonsWhole cerebellumCerebellar gray
    Difference0.05 (0.20)0.10 (0.33)0.13 (0.40)−0.12 (0.16)−0.28 (0.24)−0.37 (0.32)
    Percentage change1 (6)3 (6)4 (7)−8 (15)−15 (11)−17 (13)
    • Data in parentheses are SDs, reflecting increases in tracer retention between first and second PiB scans and between second PiB and florbetapir scans, separately for each reference region. Positive value represents mean increase from PiB1 to PiB2 or from PiB2 to florbetapir, whereas negative value represents decrease.

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Journal of Nuclear Medicine: 54 (1)
Journal of Nuclear Medicine
Vol. 54, Issue 1
January 1, 2013
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Amyloid-β Imaging with Pittsburgh Compound B and Florbetapir: Comparing Radiotracers and Quantification Methods
Susan M. Landau, Christopher Breault, Abhinay D. Joshi, Michael Pontecorvo, Chester A. Mathis, William J. Jagust, Mark A. Mintun
Journal of Nuclear Medicine Jan 2013, 54 (1) 70-77; DOI: 10.2967/jnumed.112.109009

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Amyloid-β Imaging with Pittsburgh Compound B and Florbetapir: Comparing Radiotracers and Quantification Methods
Susan M. Landau, Christopher Breault, Abhinay D. Joshi, Michael Pontecorvo, Chester A. Mathis, William J. Jagust, Mark A. Mintun
Journal of Nuclear Medicine Jan 2013, 54 (1) 70-77; DOI: 10.2967/jnumed.112.109009
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