Article Figures & Data
Figures
- FIGURE 1.
Postmortem measures of amyloid pathology. (A) Types of amyloid deposits. (B) Amyloid angiopathy. (C) Distribution of diffuse and neuritic plaques. (D) Neuritic plaque density (highest density score observed in brain). (A, B, and D are from UCSF Neurodegenerative Disease Brain Bank; C is reprinted with permission of (53).) NP = neuritic plaques.
- FIGURE 2.
Structures of thioflavin-T, 11C-PiB, 18F-flutafuranol, and Food and Drug Administration–approved Aβ PET tracers. (Reprinted from (54).)
- FIGURE 3.
Examples of negative and positive Aβ PET findings using different tracers. (18F-flutafuranol images are courtesy of Victor Villemagne and Christopher C. Rowe.)
- FIGURE 4.
Evolution of amyloid PET positivity across AD spectrum. (A) Positive 11C-PiB scan of cognitively normal (CN) participant, in which significant binding is observed in precuneus, posterior cingulate cortex, and medial prefrontal areas. (B) Positive 11C-PiB scan of MCI patient, in which significant and moderate binding is observed throughout cortex. (C) Positive 11C-PiB scan of AD patient, in which significant and severe binding is observed throughout cortex.
Tables
- TABLE 1.
Summary Guidelines for Interpretation of Amyloid PET Scans Using Different Tracers
Tracer category Tracer name Dose and acquisition protocol (clinical) Visualization Interpretation criteria for positive scan Food and Drug Administration– approved 18F-florbetaben ∼300 MBq; 15- to 20-min acquisition beginning at 45–130 min (research use, 20-min acquisition beginning at 90–110 min) Gray scale; window images to optimize GM/WM contrast in cerebellum Increased GM uptake extending to cortical margin involving most slices in at least 1 of 4 target cortical regions: frontal, parietal, precuneus/posterior cingulate, lateral temporal; regional cortical tracer uptake/brain amyloid plaque load scores (20) 18F-florbetapir ∼370 MBq; 10- to 20-min acquisition beginning at 30–50 min (package insert guidelines) for clinical use or 50–70 min (optimized kinetics for quantification) for research use Inverse gray scale; window images to optimize GM/WM contrast in cerebellum Loss of GM/WM contrast due to increased cortical binding in, first, 2 or more brain areas (each larger than single gyrus) with reduced or absent GM/WM contrast or, second, 1 or more areas with intense signal where GM > WM 18F-flutemetamol ∼185 MBq; 10- to 20-min acquisition at 60–120 min (research use, 20-min acquisition at 90–110 min) Color scale (NIH); normalize so that pons is at 90% of activity Increased GM uptake (>50%–60% peak intensity) or loss of GM matter contrast in at least 1 of 4 cortical regions and 1 subcortical region: frontal, inferolateral parietal, precuneus/posterior cingulate, lateral temporal, striatum Research 11C-PiB ∼555 MBq; dynamic 60- to 90-min acquisition (distribution volume ratio) or 20-min acquisition at 50–70 min (SUV ratio) Color scale (NIH); window images to optimize GM/WM contrast in cerebellum No formal guidelines for reading (research use only) 18F-flutafuranol ∼185 MBq; 20- to 30-min acquisition beginning at 40–50 min Color scale (NIH); window images to optimize GM/WM contrast in cerebellum No formal guidelines for reading (research use only) GM = gray matter; NIH = National Institutes of Health; WM = white matter.
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