Article Figures & Data
Figures
- FIGURE 1.
Parametric images of 11C-PE2I BPND compared with 123I-FP-CIT uptake images, illustrating DAT availability in patients diagnosed with different types of parkinsonism. a.u. = arbitrary unit; MSA-P = MSA with suggested predominated parkinsonism; normal = no notable deviation in dopaminergic function; VP = vascular parkinsonism.
- FIGURE 2.
Parametric images of 11C-PE2I relative delivery (R1) compared with 18F-FDG images normalized to cerebellum, illustrating overall brain functional activity in patients diagnosed with different types of parkinsonism. MSA-P = MSA with suggested predominant parkinsonism; normal = no notable deviation in overall brain functional activity; PSP = progressive supranuclear palsy; VP = vascular parkinsonism.
- FIGURE 3.
Parametric images of 11C-PE2I relative delivery (R1) and BPND compared with 123I-FP-CIT and 18F-FDG images, illustrating DAT availability and overall brain functional activity in patient 4, diagnosed MSA with atrophy related to cerebellum. a.u. = arbitrary unit.
- FIGURE 4.
Relationship between normalized uptake of 123I-FP-CIT and 11C-PE2I BPND for putamen (PUT) and caudate nucleus (CN).
- FIGURE 5.
Relationship between normalized uptake of 18F-FDG and 11C-PE2I R1 for anterior cortical region (ACR), posterior cortical region (PCR), basal ganglia (BG), and limbic region (LR).
Tables
Parkinson treatment Scanning interval (d) Subject Sex Age (y) H&Y staging Duration (y) Drug Daily dose (mg) PE2I–DAT PE2I–FDG 1 F 74 3 4 l-dopa 600 282 −218 2 F 73 4 7 l-dopa 1,200 −92 −92 Pramipexole 1.05 4 M 63 3 6 l-dopa 800 104 105 Ropinirole 10 5 F 77 3 8 l-dopa 500 82 82 6 F 60 3 12 Quetiapine 200 −1 −1 7 M 70 3 10 l-dopa 600 184 188 8 F 65 3 4 None 23 152 9 F 66 3 3 l-dopa 300 −1 326 Pramipexole 2.1 10 M 77 5 6 l-dopa 500 −16 −16 Pramipexole 0.54 11 F 67 2 2 l-dopa 250 −37 −37 12 M 79 2 4 l-dopa 400 −36 −36 13 F 71 2 4 l-dopa 600 373 628 14 M 71 3 3 l-dopa 400 −1 −1 15 M 58 2 1.5 l-dopa 500 154 202 16 F 67 3 2 None −1 −1 19 F 69 1 1.5 l-dopa 400 −1 −1 H&Y = Hoehn and Yahr; PE2I–DAT = days between 11C-PE2I PET and 123I-FP-CIT SPECT; PE2I–FDG = days between 11C-PE2I PET and 18F-FDG PET.
Brain region of interest Structure Volume (26) r Whole brain Gray matter 0.76 White matter 0.69 Frontal lobe Frontal gyrus (superior, medial-inferior) 0.80 Orbital frontal cortex 0.75 Dorsolateral prefrontal cortex 0.75 Ventrolateral prefrontal cortex 0.82 Anterior cingulate gyrus 0.85 Posterior cingulate gyrus 0.93 Temporal lobe Lateral temporal cortex (superior, medial-inferior) 0.76 Parietal lobe Parietal cortex 0.94 Occipital lobe Occipital cortex 0.88 Insular lobe Insula 0.79 Somatosensory and motor cortex 0.74 Basal ganglia Caudate nucleus, putamen 0.81 Limbic regions Amygdala, hippocampus, hypothalamus 0.68 Thalamus 0.76 Midbrain Midbrain 0.61 n = 15 (1 subject was disregarded because of significant neurodegeneration in cerebellum [Fig. 3]).
- TABLE 3
Comparison of Diagnosis Based on Visual Assessment of Neuroimaging Data and Clinical Assessment
Information source for diagnosis A. Parametric images of 11C-PE2I B. Normalized 123I-FP-CIT and 18F-FDG images Subject BPND Both R1 and BPND 123I-FP-CIT Both scans C. Clinical data 1 ↓ MSA ↓ MSA Probable MSA 2 ↓ MSA ↓ MSA Probable MSA 4 ↓ MSA ↓ MSA Probable MSA 5 ↓ IPD* ↓ PSP* Possible MSA†‡ 6 → Normal → Normal Possible PSP†‡ 7 ↓ IPD ↓ IPD Probable IPD 8 → Normal* → VP* CBD†‡ 9 ↓ MSA ↓ MSA Possible IPD†‡ 10 → VP* ↓ IPD* CBD†‡ 11 ↓ IPD ↓ IPD Possible DLB†‡ 12 ↓ IPD ↓ IPD Probable IPD 13 ↓ PSP* ↓ IPD* Probable IPD† 14 ↓ IPD ↓ IPD Probable MSA†‡ 15 ↓ IPD ↓ IPD Probable IPD 16 ↓ PSP ↓ PSP Probable PSP 19 → VP → VP Possible IPD†‡ ↵* Difference in diagnosis between evaluations of neuroimaging data (A and B).
↵† Difference in diagnosis based on data of A and C.
↵‡ Difference in diagnosis based on data from B and C.
PSP = progressive supranuclear palsy; Normal = no significant deviation in dopaminergic and overall function; VP = vascular parkinsonism; CBD = corticobasal degeneration; DLB = dementia with Lewy bodies; ↓ = significant decrease in observed level of DAT availability; → = no notable deviation from normal.
11C-PE2I BPND and 123I-FP-CIT SPECT images reflect DAT availability, whereas11C-PE2I R1 and 18F-FDG PET images mirror overall brain functional activity.
