title: 11C-PIB PET imaging in Alzheimer disease and frontotemporal lobar degeneration.
abstract: BACKGROUND
  The PET tracer (11)C-labeled Pittsburgh Compound-B ((11)C-PIB) specifically binds fibrillar amyloid-beta (Abeta) plaques and can be detected in Alzheimer disease (AD). We hypothesized that PET imaging with (11)C-PIB would discriminate AD from frontotemporal lobar degeneration (FTLD), a non-Abeta dementia.
  
  
  METHODS
  Patients meeting research criteria for AD (n = 7) or FTLD (n = 12) and cognitively normal controls (n = 8) underwent PET imaging with (11)C-PIB (patients and controls) and (18)F-fluorodeoxyglucose ((18)F-FDG) (patients only). (11)C-PIB whole brain and region of interest (ROI) distribution volume ratios (DVR) were calculated using Logan graphical analysis with cerebellum as a reference region. DVR images were visually rated by a blinded investigator as positive or negative for cortical (11)C-PIB, and summed (18)F-FDG images were rated as consistent with AD or FTLD.
  
  
  RESULTS
  All patients with AD (7/7) had positive (11)C-PIB scans by visual inspection, while 8/12 patients with FTLD and 7/8 controls had negative scans. Of the four PIB-positive patients with FTLD, two had (18)F-FDG scans that suggested AD, and two had (18)F-FDG scans suggestive of FTLD. Mean DVRs were higher in AD than in FTLD in whole brain, lateral frontal, precuneus, and lateral temporal cortex (p < 0.05), while DVRs in FTLD did not significantly differ from controls.
  
  
  CONCLUSIONS
  PET imaging with (11)C-labeled Pittsburgh Compound-B ((11)C-PIB) helps discriminate Alzheimer disease (AD) from frontotemporal lobar degeneration (FTLD). Pathologic correlation is needed to determine whether patients with PIB-positive FTLD represent false positives, comorbid FTLD/AD pathology, or AD pathology mimicking an FTLD clinical syndrome.
authors.affiliation: Memory &Aging Center, University of California San Fransisco, San Francisco, CA 94117, USA. grabinovici@memory.ucsf.edu
authors.forename: G D
authors.initials: GD
authors.lastname: Rabinovici
authors.forename: A J
authors.initials: AJ
authors.lastname: Furst
authors.forename: J P
authors.initials: JP
authors.lastname: O'Neil
authors.forename: C A
authors.initials: CA
authors.lastname: Racine
authors.forename: E C
authors.initials: EC
authors.lastname: Mormino
authors.forename: S L
authors.initials: SL
authors.lastname: Baker
authors.forename: S
authors.initials: S
authors.lastname: Chetty
authors.forename: P
authors.initials: P
authors.lastname: Patel
authors.forename: T A
authors.initials: TA
authors.lastname: Pagliaro
authors.forename: W E
authors.initials: WE
authors.lastname: Klunk
authors.forename: C A
authors.initials: CA
authors.lastname: Mathis
authors.forename: H J
authors.initials: HJ
authors.lastname: Rosen
authors.forename: B L
authors.initials: BL
authors.lastname: Miller
authors.forename: W J
authors.initials: WJ
authors.lastname: Jagust
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging*; D000814:Aniline Compounds; D052160:Benzothiazoles; D001921:Brain / Q000000981:diagnostic imaging*; D003704:Dementia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013844:Thiazoles
chemical_list: C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D000814:Aniline Compounds; D052160:Benzothiazoles; D019275:Radiopharmaceuticals; D013844:Thiazoles