11C-PIB binding is increased in patients with cerebral amyloid angiopathy-related hemorrhage.
BACKGROUND
The in vivo diagnosis of cerebral amyloid angiopathy (CAA) is inferred from clinical and structural imaging features. (11)C-Pittsburgh compound B (PIB) is a PET ligand that binds to beta-amyloid in extracellular plaques and vessel walls. We hypothesized that patients with a clinical diagnosis of CAA-related hemorrhage (CAAH) have increased (11)C-PIB uptake and that the pattern differs from Alzheimer disease (AD).


METHODS
Patients with CAAH based on established clinical criteria were studied using (11)C-PIB PET and were compared with age-matched controls and patients with AD. Distribution volume ratio (DVR) parametric maps were created using the cerebellar cortex as a reference region.


RESULTS
Twelve patients with CAAH of mean age 73.9 (range 58-93) years were compared with 22 normal controls and 13 patients with AD of mean age 71.8 (59-83) and 73.8 (56-90) years, respectively. CAAH PIB median DVR binding was higher in cortical regions (1.69, interquartile range 1.44-1.97) compared with controls (1.32, 1.21-1.44, p = 0.002) but lower than AD (2.04, 1.93-2.26, p = 0.004). The occipital-global uptake ratio was lower among patients with AD than among patients with CAAH (p = 0.008), and the frontal-global uptake ratio was higher (p = 0.012).


CONCLUSIONS
(11)C-Pittsburgh compound B (PIB) binding is moderately increased in most patients with probable cerebral amyloid angiopathy (CAA)-related intracerebral hemorrhage. The distribution may differ from that seen in Alzheimer disease. (11)C-PIB PET may assist in the in vivo diagnosis of CAA and serve as a surrogate marker for future therapeutic studies.
Ly
J V
JV
National Stroke Research Institute, Level 1, Neurosciences Building, Austin Health, University of Melbourne, 300 Waterdale Rd., Heidelberg Heights, Victoria 3081, Australia.
Donnan
G A
GA
Villemagne
V L
VL
Zavala
J A
JA
Ma
H
H
O'Keefe
G
G
Gong
S J
SJ
Gunawan
R M
RM
Saunder
T
T
Ackerman
U
U
Tochon-Danguy
H
H
Churilov
L
L
Phan
T G
TG
Rowe
C C
CC
D000368:Aged; D000369:Aged, 80 and over; D000814:Aniline Compounds; D052160:Benzothiazoles / Q000378:metabolism*; D002250:Carbon Radioisotopes / Q000378:metabolism*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006470:Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013844:Thiazoles
C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D000814:Aniline Compounds; D052160:Benzothiazoles; D002250:Carbon Radioisotopes; D013844:Thiazoles