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“Pharmacokinetic modelling for the simultaneous assessment of perfusion and ¹⁸F-flutemetamol uptake in cerebral amyloid angiopathy using a reduced PET-MR acquisition time: proof of concept.

Papanastasiou, Georgios and Mark, Rodrigues and Chengjia, Wang and Kerstin, Heurling and Christophe, Lucatelli and Rustam, Al-Shahi Salman and Joanna M., Wardlaw and Edwin J.R., van Beek and Gerard, Thompson (2021) '“Pharmacokinetic modelling for the simultaneous assessment of perfusion and ¹⁸F-flutemetamol uptake in cerebral amyloid angiopathy using a reduced PET-MR acquisition time: proof of concept.' NeuroImage, 225. ISSN 1053-8119

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Abstract

Purpose Cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease associated with perivascular β-amyloid deposition. CAA is also associated with strokes due to lobar intracerebral haemorrhage (ICH). 18F-flutemetamol amyloid ligand PET may improve the early detection of CAA. We performed pharmacokinetic modelling using both full (0–30, 90–120 min) and reduced (30 min) 18F-flutemetamol PET-MR acquisitions, to investigate regional cerebral perfusion and amyloid deposition in ICH patients. Methods Dynamic 18F-flutemetamol PET-MR was performed in a pilot cohort of sixteen ICH participants; eight lobar ICH cases with probable CAA and eight deep ICH patients. A model-based input function (mIF) method was developed for compartmental modelling. mIF 1-tissue (1-TC) and 2-tissue (2-TC) compartmental modelling, reference tissue models and standardized uptake value ratios were assessed in the setting of probable CAA detection. Results The mIF 1-TC model detected perfusion deficits and 18F-flutemetamol uptake in cases with probable CAA versus deep ICH patients, in both full and reduced PET acquisition time (all P < 0.05). In the reduced PET acquisition, mIF 1-TC modelling reached the highest sensitivity and specificity in detecting perfusion deficits (0.87, 0.77) and 18F-flutemetamol uptake (0.83, 0.71) in cases with probable CAA. Overall, 52 and 48 out of the 64 brain areas with 18F-flutemetamol-determined amyloid deposition showed reduced perfusion for 1-TC and 2-TC models, respectively. Conclusion Pharmacokinetic (1-TC) modelling using a 30 min PET-MR time frame detected impaired haemodynamics and increased amyloid load in probable CAA. Perfusion deficits and amyloid burden co-existed within cases with CAA, demonstrating a distinct imaging pattern which may have merit in elucidating the pathophysiological process of CAA.

Item Type: Article
Uncontrolled Keywords: Positron emission tomography, Magnetic resonance imaging, Pharmacokinetic modelling, Perfusion, 18F-flutemetamol uptake, Cerebral amyloid angiopathy
Divisions: Faculty of Science and Health > Computer Science and Electronic Engineering, School of
Depositing User: Elements
Date Deposited: 09 Feb 2021 09:50
Last Modified: 09 Feb 2021 09:50
URI: http://repository.essex.ac.uk/id/eprint/29095

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