title: Partial-Volume Effect Correction Improves Quantitative Analysis of 18F-Florbetaben β-Amyloid PET Scans.
abstract: Neocortical atrophy reduces PET signal intensity, potentially affecting the diagnostic efficacy of β-amyloid (Aβ) brain PET imaging. This study investigated whether partial-volume effect correction (PVEC), adjusting for this atrophy bias, improves the accuracy of (18)F-florbetaben Aβ PET.
  
  
  METHODS
  We analyzed (18)F-florbetaben PET and MRI data obtained from 3 cohorts. The first was 10 patients with probable Alzheimer disease (AD) and 10 age-matched healthy controls (HCs), the second was 31 subjects who underwent in vivo imaging and postmortem histopathology for Aβ plaques, and the third was 5 subjects who underwent PET and MRI at baseline and 1 y later. The imaging data were coregistered and segmented. PVEC was performed using the voxel-based modified Müller-Gärtner method (PVELab, SPM8). From the PET data, regional and composite SUV ratios (SUVRs) with and without PVEC were obtained. In the MRI data, mesial temporal lobe atrophy was determined by the Scheltens mesial temporal atrophy scale and gray matter volumes by voxel-based morphometry.
  
  
  RESULTS
  In cohort 1, PVEC increased the effect on AD-versus-HC discrimination from a Cohen d value of 1.68 to 2.0 for composite SUVRs and from 0.04 to 1.04 for mesial temporal cortex SUVRs. The PVEC-related increase in mesial temporal cortex SUVR correlated with the Scheltens score (r = 0.84, P < 0.001), and that of composite SUVR correlated with the composite gray matter volume (r = -0.75, P < 0.001). In cohort 2, PVEC increased the correlation coefficient between mesial temporal cortex SUVR and histopathology score for Aβ plaque load from 0.28 (P = 0.09) to 0.37 (P = 0.03). In cohort 3, PVEC did not affect the composite SUVR dynamics over time for the Aβ-negative subject. This finding was in contrast to the 4 Aβ-positive subjects, in 2 of whom PVEC changed the composite SUVR dynamics.
  
  
  CONCLUSIONS
  The influence of PVEC on (18)F-florbetaben PET data is associated with the degree of brain atrophy. Thus, PVEC increases the ability of (18)F-florbetaben PET to discriminate between AD patients and HCs, to detect Aβ plaques in the atrophic mesial temporal cortex, and potentially to evaluate changes in brain Aβ load over time. As such, the use of PVEC should be considered for quantitative (18)F-florbetaben PET scans, especially in assessing patients with brain atrophy.
authors.affiliation: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany rullmann@medizin.uni-leipzig.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Rullmann
authors.affiliation: LREN, Département des Neurosciences Cliniques, CHUV, Université de Lausanne, Lausanne, Switzerland Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Dukart
authors.affiliation: Department of Neuroradiology, University of Leipzig, Leipzig, Germany.
authors.forename: Karl-Titus
authors.initials: KT
authors.lastname: Hoffmann
authors.affiliation: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Luthardt
authors.affiliation: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Solveig
authors.initials: S
authors.lastname: Tiepolt
authors.affiliation: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Patt
authors.affiliation: Department of Psychiatry, University of Leipzig, Leipzig, Germany.
authors.forename: Hermann-Josef
authors.initials: HJ
authors.lastname: Gertz
authors.affiliation: Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany.
authors.forename: Matthias L
authors.initials: ML
authors.lastname: Schroeter
authors.affiliation: Molecular NeuroImaging, L.L.C., New Haven, Connecticut; and.
authors.forename: John
authors.initials: J
authors.lastname: Seibyl
authors.affiliation: Department of Neuropathology, University Medical Center, Goettingen, Germany.
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Schulz-Schaeffer
authors.affiliation: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Osama
authors.initials: O
authors.lastname: Sabri
authors.affiliation: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Henryk
authors.initials: H
authors.lastname: Barthel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D016229:Amyloid beta-Peptides / Q000378:metabolism*; D000814:Aniline Compounds; D001284:Atrophy; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D058225:Plaque, Amyloid / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013267:Stilbenes; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D016229:Amyloid beta-Peptides; D000814:Aniline Compounds; D019275:Radiopharmaceuticals; D013267:Stilbenes; C527756:4-(N-methylamino)-4'-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy)stilbene
keywords: PET; florbetaben; partial-volume effect correction; positron emission tomography; β-amyloid