部分体积效应校正削弱了[18F]-THK-5351 PET在非流利语法变异性原发性进行性失语症中的诊断作用

IF 3.4 2区医学 Q2 NEUROIMAGING

Neuroimage-Clinical Pub Date : 2025-01-01 DOI:10.1016/j.nicl.2025.103789

Patrick J. Sommer , Sebastian Schuster , Oliver Goldhardt , Nobuyuki Okamura , Felix Mueller-Sarnowski , Maximilian Scheifele , Florian Eckenweber , Annika Kreuzer , Maria Griessl , Peter Bartenstein , Thomas Wegehaupt , Lucas Wolski , Josef Priller , Axel Rominger , Leonie Beyer , Timo Grimmer , Matthias Brendel

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引用次数: 0

摘要

目的在神经退行性疾病中，由于皮层萎缩的增加，正电子发射断层扫描的部分体积效应经常发生，额颞叶痴呆通常以严重萎缩为特征。本研究的目的是挑战用[18F]-THK-5351 PET成像的非流畅语法变异性原发性进行性失语症（nfv-PPA）患者的部分体积效应矫正（PVEC），这是反应性神经炎性星形胶质细胞增生和tau结合的标志物。方法20例nfv-PPA患者采用[18F]-THK-5351 PET伴磁共振成像（MRI）成像。在进行基于区域的体素PVEC之前和之后，将hammer图谱的区域特异性皮质灰质体积和标准摄取值比（SUVr）与8个健康对照（HC）（n = 8）数据进行比较。我们评估了PVEC前后nfv-PPA与对照之间的区域方差系数（CoV）和具有显著[18F]-THK-5351 PET信号差异的区域数量。此外，在PVEC前后，由三名核医学医师（共识）进行盲法视觉阅读。结果在PVEC之前，nfv-PPA患者的双侧额叶皮层[18F]-THK-5351示踪剂摄取明显高于HC(左>；右)，尽管nfv-PPA患者的相同脑区有明显的灰质萎缩。脑额区PVEC进一步增加了nfv-PPA与HC之间的SUVr差异，但组水平方差平行增加，减少了nfv-PPA与HC之间SUVr的显著差异数（未校正：10个显著区，CoV[nfv-PPA]: 20.8%±4.7%,CoV[HC]: 7.9%±2.4% /PVEC: 3个显著区，CoV[nfv-PPA]: 28.4%±8.9%,CoV[HC]: 9.8%±2.5%）。无PVEC目测法检测nfv-PPA的灵敏度/特异性为0.85/1.00，有PVEC目测法检测nfv-PPA的灵敏度/特异性为0.85/0.75。结论[18F]-THK-5351 PET有助于检测严重萎缩的nfvPPA患者的病理改变。PVEC增加了nfv-PPA和HC患者之间的定量SUVr差异，但在组水平上引入了平行增加的方差。nfv-PPA患者对[18F]-THK-5351图像的视觉评估由于特异性丧失而受到PVEC的损害，即使在严重萎缩的患者中也不支持使用PVEC。

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Partial volume effect correction impairs the diagnostic utility of [18F]-THK-5351 PET in nonfluent-agrammatic variant primary progressive aphasia

Objectives

Partial volume effects in positron emission tomography occur frequently in neurodegenerative diseases due to increasing cortical atrophy during the disease course, and fronto-temporal dementia is often characterized by severe atrophy. The aim of this study was to challenge partial volume effect correction (PVEC) in patients with nonfluent-agrammatic variant primary progressive aphasia (nfv-PPA) imaged with [¹⁸F]-THK-5351 PET a marker of reactive neuroinflammatory astrogliosis as well as tau-binding.

Methods

Patients with nfv-PPA (n = 20) were imaged with [¹⁸F]-THK-5351 PET accompanied by structural magnetic resonance tomography imaging (MRI). Region specific cortical grey matter volumes and standard uptake value ratios (SUVr) of the Hammers atlas were compared with eight healthy control (HC) (n = 8) data before and after performing region-based voxel-wise PVEC. We evaluated regional coefficients of variance (CoV) and the number of regions with significant [¹⁸F]-THK-5351 PET signal differences between nfv-PPA and controls before and after PVEC. Additionally, a blinded visual read was performed by three nuclear medicine physicians (consensus) before and after PVEC.

Results

Prior to PVEC, [¹⁸F]-THK-5351 tracer uptake was significantly higher in the bilateral frontal cortex of patients with nfv-PPA when compared to HC (left > right), despite significant grey matter atrophy in the same brain regions in patients with nfv-PPA. SUVr differences between nfv-PPA and HC were further increased by PVEC in frontal brain regions, but group level variance increased in parallel and reduced the number of significant differences between SUVr of nfv-PPA and HC (uncorrected: 10 significant regions, CoV[nfv-PPA]: 20.8 % ± 4.7 %, CoV[HC]: 7.9 % ± 2.4 %/PVEC: 3 significant regions, CoV[nfv-PPA]: 28.4 % ± 8.9 %, CoV[HC]: 9.8 % ± 2.5 %). Sensitivity/specificity of the visual read for detection of nfv-PPA was 0.85/1.00 without PVEC and 0.85/0.75 with PVEC.

Conclusions

[¹⁸F]-THK-5351 PET facilitates detection of pathological alterations in patients with nfvPPA with severe atrophy. PVEC increases quantitative SUVr differences between patients with nfv-PPA and HC but introduces a parallel increase of variance at the group level. Visual assessment of [¹⁸F]-THK-5351 images in patients with nfv-PPA is impaired by PVEC due to loss of specificity and does not support the use of PVEC even in patients with severe atrophy.

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.