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Research ArticleClinical Investigations

18F-Florbetapir PET in Patients with Frontotemporal Dementia and Alzheimer Disease

Christopher Kobylecki, Tobias Langheinrich, Rainer Hinz, Emma R.L.C. Vardy, Gavin Brown, María-Elena Martino, Cathleen Haense, Anna M. Richardson, Alexander Gerhard, Jose M. Anton-Rodriguez, Julie S. Snowden, David Neary, Michael J. Pontecorvo and Karl Herholz
Journal of Nuclear Medicine March 2015, 56 (3) 386-391; DOI: https://doi.org/10.2967/jnumed.114.147454
Christopher Kobylecki
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
2Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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Tobias Langheinrich
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
2Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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Rainer Hinz
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
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Emma R.L.C. Vardy
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
3Institute of Neuroscience and Newcastle University Institute of Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom
4Department of Older Peoples Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Gavin Brown
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
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María-Elena Martino
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
5Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Cathleen Haense
6Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
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Anna M. Richardson
2Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, United Kingdom
7Manchester Medical School, University of Manchester, Manchester, United Kingdom; and
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Alexander Gerhard
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
2Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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Jose M. Anton-Rodriguez
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
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Julie S. Snowden
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
2Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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David Neary
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
2Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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Michael J. Pontecorvo
8Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
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Karl Herholz
1Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
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  • FIGURE 1.
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    FIGURE 1.

    Whole neocortical 18F-florbetapir SUVRs relative to cerebellar gray matter in patients with AD and FTD and healthy controls. Points represent individual subject values and bars median values (Kruskal–Wallis test followed by pairwise post hoc test corrected for multiple comparisons). Subjects in whom most visual interpretation was discordant from their clinical diagnosis are indicated as open symbols.

  • FIGURE 2.
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    FIGURE 2.

    Gray-scale 18F-florbetapir scans as used for visual interpretation. (A) Patient 4 in Supplemental Table 1, patient 12 (B), patient 18 (C), patient 11 (D).

  • FIGURE 3.
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    FIGURE 3.

    Transaxial coregistered images from FTD subject with discordant visual interpretations (subject 15 in Supplemental Table 1) of gray-scale 18F-florbetapir PET (A), T1-weighted MR brain (B), and color-scale 18F-florbetapir PET fused to MR brain (C). Arrows indicate apparent areas of high 18F-florbetapir uptake as a result of loss of contrast due to low white matter uptake or cortical atrophy leading to inconsistent visual interpretations.

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    TABLE 1

    Demographic Information on Subjects Recruited to Study

    CharacteristicHealthy controls (n = 10)FTD (n = 8)AD (n = 10)
    Age (y)62.5 ± 5.162.5 ± 9.662.6 ± 4.5
    Sex
     Male487
     Female63
    Disease duration (y)—4.6 ± 1.84.9 ± 1.7
    MMSE3026.5 (0–30)18.0 (10–24)
    Total Clinical Dementia Rating score01.0 (0.5–2.0)1.0 (0.5–2.0)
    APOE ε4 carriers (0/1/2 gene copies)—4/3/14/3/3
    • Data are mean ± SD for age and disease duration and median (with range in parentheses) in all other cases.

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    TABLE 2

    Regional 18F-Florbetapir Uptake Ratios Normalized to Gray Matter Cerebellar Uptake for Subjects with FTD and AD and Healthy Controls

    ROIPControlFTDAD
    Mesial temporal cortex0.0141.08 (0.23)0.97 (0.09)*1.18 (0.16)
    Temporal cortex0.0021.21 (0.17)1.08 (0.22)†1.54 (0.58)
    Frontal cortex0.0011.29 (0.16)*1.17 (0.18)†1.85 (0.88)
    Anterior cingulate cortex0.0021.38 (0.29)*1.21 (0.23)†1.91 (0.89)
    Posterior cingulate cortex0.0041.31 (0.22)*1.20 (0.43)†1.94 (0.85)
    Parietal cortex0.0041.31 (0.16)*1.21 (0.29)†1.85 (0.77)
    Occipital cortex0.0011.31 (0.16)*1.18 (0.19)†1.67 (0.41)
    Caudate nucleus0.0011.04 (0.13)†1.02 (0.22)†1.31 (0.34)
    Putamen0.0011.31 (0.23)†1.34 (0.19)*2.09 (0.74)
    Thalamus0.0031.09 (0.13)1.03 (0.18)†1.22 (0.17)
    Brain stem0.9931.20 (0.16)1.19 (0.26)1.18 (0.21)
    Whole-brain white matter0.242.51 (0.63)2.34 (0.54)2.59 (0.55)
    • ↵* P < 0.05 vs. AD (Kruskal–Wallis test followed by post hoc pairwise tests adjusted for multiple comparisons).

    • ↵† P < 0.01 vs. AD (Kruskal–Wallis test followed by post hoc pairwise tests adjusted for multiple comparisons).

    • Data are presented as median, with interquartile range in parentheses, in all cases.

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Journal of Nuclear Medicine: 56 (3)
Journal of Nuclear Medicine
Vol. 56, Issue 3
March 1, 2015
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18F-Florbetapir PET in Patients with Frontotemporal Dementia and Alzheimer Disease
Christopher Kobylecki, Tobias Langheinrich, Rainer Hinz, Emma R.L.C. Vardy, Gavin Brown, María-Elena Martino, Cathleen Haense, Anna M. Richardson, Alexander Gerhard, Jose M. Anton-Rodriguez, Julie S. Snowden, David Neary, Michael J. Pontecorvo, Karl Herholz
Journal of Nuclear Medicine Mar 2015, 56 (3) 386-391; DOI: 10.2967/jnumed.114.147454

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18F-Florbetapir PET in Patients with Frontotemporal Dementia and Alzheimer Disease
Christopher Kobylecki, Tobias Langheinrich, Rainer Hinz, Emma R.L.C. Vardy, Gavin Brown, María-Elena Martino, Cathleen Haense, Anna M. Richardson, Alexander Gerhard, Jose M. Anton-Rodriguez, Julie S. Snowden, David Neary, Michael J. Pontecorvo, Karl Herholz
Journal of Nuclear Medicine Mar 2015, 56 (3) 386-391; DOI: 10.2967/jnumed.114.147454
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