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Dynamic 18F-FPCIT PET: Quantification of Parkinson Disease Metabolic Networks and Nigrostriatal Dopaminergic Dysfunction in a Single Imaging Session

Shichun Peng, Chris Tang, Katharina Schindlbeck, Yaacov Rydzinski, Vijay Dhawan, Phoebe G. Spetsieris, Yilong Ma and David Eidelberg
Journal of Nuclear Medicine December 2021, 62 (12) 1775-1782; DOI: https://doi.org/10.2967/jnumed.120.257345

Article Figures & Data

Figures

  • Figure
  • FIGURE 1.
    FIGURE 1.

    Mean images of PD patients and HCs from early-phase 18F-FPCIT and 18F-FDG PET after spatial normalization into a standard brain space. There was high similarity between mean 18F-FPCIT images over first 2, 5, and 10 min after injection and corresponding 18F-FDG images.

  • FIGURE 2.
    FIGURE 2.

    Differences in network scores and striatal DAT binding in PD patients compared with age-matched HC subjects. (A and B) Elevation in PDRP but not PDCP expression with pseudo-cerebral blood flow images from early-phase 18F-FPCIT PET (0–2, 0–5, and 0–10 min) and metabolic images from 18F-FDG PET. (C) Reduction in striatal DAT binding in caudate, putamen, and subdivisions of putamen from late-phase 18F-FPCIT PET over 90–100 min. SOR = striatal-occipital ratio. *P < 0.05, unpaired Student t test. ***P < 0.001, unpaired Student t test.

  • FIGURE 3.
    FIGURE 3.

    Correlations in network scores between surrogate cerebral blood flow images from early-phase 18F-FPCIT and metabolic images in PD patients. (A and B) PDRP/PDCP expression computed using 18F-FPCIT PET over 0–10 min correlated closely with that obtained with 18F-FDG PET in same subjects (PDRP: r = 0.863, P < 0.0001; PDCP: r = 0.675, P < 0.005; Pearson correlations). (C and D) Corresponding PDCP expression correlated with PDRP expression (r = 0.750, P < 0.0001) and DAT binding in caudate (r = −0.404, P < 0.05). SOR = striatal-occipital ratio.

  • FIGURE 4.
    FIGURE 4.

    Longitudinal changes in network scores and striatal DAT binding in PD patients who underwent repeat PET imaging with both 18F-FPCIT and 18F-FDG. (A, B, D, and E) Increases in PDRP and PDCP expression (P < 0.02, paired Student t tests) with proxy cerebral blood flow images from early-phase 18F-FPCIT PET over 0–10 min and metabolic images. (C and F) Reduction in striatal DAT binding (P < 0.05) in putamen and caudate from late-phase 18F-FPCIT PET over 90–100 min. (Color codes are same for 7 PD subjects with dual-tracer data, with different colors for 2 other subjects with either 18F-FPCIT or 18F-FDG PET.) SOR = striatal-occipital ratio.

Tables

  • TABLE 1

    Demographic and Clinical Characteristics of HC Subjects and PD Patients

    ParameternAge (y)Sex (F/M)HY stageDuration (y)UPDRS motor
    18F-FPCIT
     HC1652.8 ± 17.111/5NANANA
     PD2560.0 ± 10.86/191.6 ± 1.04.8 ± 4.912.2 ± 9.6
     PD1862.6 ± 7.10/81.2 ± 0.43.0 ± 3.18.4 ± 5.1
     PD2*66.4 ± 7.82.2 ± 0.46.8 ± 3.516.9 ± 5.0
    18F-FDG
     HC759.3 ± 13.53/4NANANA
     PD1860.4 ± 9.04/141.3 ± 0.42.8 ± 1.79.4 ± 4.9
     PD1859.2 ± 8.01/71.2 ± 0.42.0 ± 1.39.6 ± 4.8
     PD2*63.0 ± 8.42.1 ± 0.45.8 ± 1.417.4 ± 4.9

    • *P < 0.0001, paired Student t tests of follow-up data compared with baseline.

    • HY= Hoehn and Yahr; UPDRS = unified PD rating scale; NA = not applicable.

    • PD1 and PD2 refer to baseline and 4-y scans of longitudinal PD group. Of 8 PD patients with follow-up, 7 had both 18F-FPCIT and 18F-FDG PET whereas the others underwent imaging with either tracer. Data are mean ± SD.

  • TABLE 2

    Correlations Between Clinical Data and PDRP Scores or Striatal DAT Binding Values in PD Patients

    ParameterUPDRSDuration18F-FPCIT over 0-2 min18F-FPCIT over 0-5 min18F-FPCIT over 0-10 min
    PDRP score
     18F-FPCIT over 0-2 min0.423*0.391
     18F-FPCIT over 0-5 min0.438*0.407*0.983†
     18F-FPCIT over 0-10 min0.439*0.409*0.954†0.992†
     18F-FDG0.754†0.837†0.863†
    Striatal DAT binding
     Caudate−0.256−0.290−0.306
     Putamen (whole)−0.304−0.301−0.289
     Anterior−0.270−0.273−0.266
     Middle−0.356−0.351−0.342
     Posterior−0.319−0.307−0.297

    • *P < 0.05.

    • ↵†P < 0.0001.

    • UPDRS = unified PD rating scale.

    • Data are Pearson correlation coefficients.

  • TABLE 3

    Correlations Between Clinical Data and PDCP Scores or Striatal DAT Binding Values in PD Patients

    ParameterUPDRSDuration18F-FPCIT over 0-2 min18F-FPCIT over 0-5 min18F-FPCIT over 0-10 min
    PDCP score
     18F-FPCIT over 0-2 min0.2400.483*
     18F-FPCIT over 0-5 min0.3180.483*0.939†
     18F-FPCIT over 0-10 min0.3390.457*0.865†0.983†
     18F-FDG0.510*0.641‡0.675‡
    Striatal DAT binding
     Caudate−0.446*−0.430*−0.404*
     Putamen (whole)−0.380−0.345−0.299
     Anterior−0.481*−0.419*−0.365
     Middle−0.386−0.368−0.334
     Posterior−0.264−0.259−0.237

    • *P < 0.05.

    • ↵†P < 0.0001.

    • ↵‡P < 0.005.

    • UPDRS = unified PD rating scale.

    • Data are Pearson correlation coefficients.

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