title: Early-Phase 11C-PiB PET in Amyloid Angiopathy-Related Symptomatic Cerebral Hemorrhage: Potential Diagnostic Value?
abstract: Although late-phase (>35min post-administration) 11C-PiB-PET has good sensitivity in cerebral amyloid angiopathy (CAA), its specificity is poor due to frequently high uptake in healthy aged subjects. By detecting perfusion-like abnormalities, early-phase 11C-PiB-PET might add diagnostic value. Early-frame (1-6min) 11C-PiB-PET was obtained in 11 non-demented patients with probable CAA-related symptomatic lobar intracerebral haemorrhage (70±7yrs), 9 age-matched healthy controls (HCs) and 10 HCs <55yrs. There was a significant decrease in early-phase atrophy-corrected whole-cortex SUV relative to cerebellar vermis (SUVR) in the CAA vs age-matched HC group. None of the age-matched controls fell below the lower 95% confidence limit derived from the young HCs, while 6/11 CAA patients did (sensitivity = 55%, specificity = 100%). Combining both early- and late-phase 11C-PiB data did not change the sensitivity and specificity of late-phase PiB, but combined early- and late-phase positivity entails a very high suspicion of underlying Aβ-related clinical disorder, i.e., CAA or Alzheimer disease (AD). In order to clarify this ambiguity, we then show that the occipital/posterior cingulate ratio is markedly lower in CAA than in AD (N = 7). These pilot data suggest that early-phase 11C-PiB-PET may not only add to late-phase PiB-PET with respect to the unclear situation of late-phase positivity, but also help differentiate CAA from AD.
authors.affiliation: APHP, Hotel-Dieu Hospital, Department of Nuclear Medicine, Paris, France; Dept of Nuclear Medicine, Martinique University Hospital, Fort-de-France, French West Indies.
authors.forename: Karim
authors.initials: K
authors.lastname: Farid
authors.affiliation: Wolfson Brain Imaging Centre, Dept of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Young T
authors.initials: YT
authors.lastname: Hong
authors.affiliation: Wolfson Brain Imaging Centre, Dept of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Franklin I
authors.initials: FI
authors.lastname: Aigbirhio
authors.affiliation: Wolfson Brain Imaging Centre, Dept of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Tim D
authors.initials: TD
authors.lastname: Fryer
authors.affiliation: Division of Anesthesia, University of Cambridge, Cambridge, United Kingdom.
authors.forename: David K
authors.initials: DK
authors.lastname: Menon
authors.affiliation: Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom; Stroke Unit, Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Warburton
authors.affiliation: Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom; INSERM U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Baron
mesh_terms: D000368:Aged; D000814:Aniline Compounds; D001921:Brain / Q000000981:diagnostic imaging*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013844:Thiazoles
chemical_list: C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D000814:Aniline Compounds; D019275:Radiopharmaceuticals; D013844:Thiazoles