Evaluation of 18F-RO-948 PET for Quantitative Assessment of Tau Accumulation in the Human Brain

J Nucl Med. 2018 Dec;59(12):1877-1884. doi: 10.2967/jnumed.118.214437. Epub 2018 Aug 10.

Abstract

The availability of tau PET radioligands enables quantitative assessment of tau density and distribution in the human brain. We evaluated the kinetics of a novel radioligand, 18F-RO-948 (previously referred to as 18F-RO6958948), and its ability to identify tau positivity in individual patients with mild Alzheimer disease (AD). Methods: Eleven subjects with amyloid-positive mild AD, 5 amyloid-negative older control subjects (OC), and 5 younger control subjects (YC) completed 1 or 2 (4 AD and 5 OC) PET scans with 18F-RO-948 for 90, 120, or 200 min. The kinetics of the radioligand was evaluated with standard compartmental and noncompartmental models (with plasma data in 70% of cases), tissue-reference methods, and SUV ratio. These approaches were applied to assess the ability of 18F-RO-948 to discriminate AD subjects from OC subjects. Results: The plasma reference graphical analysis appeared to be the optimal method of quantification for 18F-RO-948, yielding strictly time-consistent values of distribution volume and distribution volume ratio at 90 min against the analyses at 120 and 200 min. The reference tissue graphical analysis and SUV ratio were cross-validated against plasma reference graphical analysis. Test-retest evaluation showed excellent reproducibility. A proposed novel index of tau load, the regional tau-positive fraction, showed high values in the medial and lateral temporal and parietal regions in AD and successfully separated AD subjects from OC and YC subjects with a significant margin. Conclusion:18F-RO-948 appears to be a promising radioligand for quantitative imaging of tau in the brain of AD patients.

Keywords: 18F-RO6958948 for tau imaging; Alzheimer disease; PET; neurology; radiotracer tissue kinetics.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alzheimer Disease / diagnostic imaging*
  • Alzheimer Disease / metabolism*
  • Brain / diagnostic imaging*
  • Brain / metabolism*
  • Case-Control Studies
  • Female
  • Fluorine Radioisotopes
  • Functional Neuroimaging / methods*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Models, Neurological
  • Positron-Emission Tomography / methods*
  • Radioligand Assay
  • Radiopharmaceuticals* / pharmacokinetics
  • Reproducibility of Results
  • Young Adult
  • tau Proteins / metabolism*

Substances

  • Fluorine Radioisotopes
  • MAPT protein, human
  • Radiopharmaceuticals
  • tau Proteins
  • Fluorine-18