Evaluation of 10-minute post-injection11C-PiB PET and its correlation with18F-FDG PET in older adults who are cognitively healthy, mildly impaired, or with probable Alzheimer’s disease

Abstract

Objective: Positron emission tomography (PET) allows in vivo evaluation of molecular targets in neurodegenerative diseases, such as Alzheimer’s disease. Mild cognitive impairment is an intermediate stage between normal cognition and Alzheimer-type dementia. In vivo fibrillar amyloid-beta can be detected in PET using [11C]-labeled Pittsburgh compound B (11C-PiB). In contrast, [18F] fluoro-2-deoxy-d-glucose (18F-FDG) is a neurodegeneration biomarker used to evaluate cerebral glucose metabolism, indicating neuronal injury and synaptic dysfunction. In addition, early cerebral uptake of amyloid-PET tracers can determine regional cerebral blood flow. The present study compared early-phase11C-PiB and18F-FDG in older adults without cognitive impairment, amnestic mild cognitive impairment, and clinical diagnosis of probable Alzheimer’s disease. Methods: We selected 90 older adults, clinically classified as healthy controls, with amnestic mild cognitive impairment, or with probable Alzheimer’s disease, who underwent an18F-FDG PET, early-phase11C-PiB PET and magnetic resonance imaging. All participants were also classified as amyloid-positive or-negative in late-phase11C-PiB. The data were analyzed using statistical parametric mapping. Results: We found that the probable Alzheimer’s disease and amnestic mild cognitive impairment group had lower early-phase11C-PiB uptake in limbic structures than18F-FDG uptake. The images showed significant interactions between amyloid-beta status (negative or positive). However, early-phase11C-PiB appears to provide different information from18F-FDG about neurodegeneration. Conclusions: Our study suggests that early-phase11C-PiB uptake correlates with18F-FDG, irrespective of the particular amyloid-beta status. In addition, we observed distinct regional distribution patterns between both biomarkers, reinforcing the need for more robust studies to investigate the real clinical value of early-phase amyloid-PET imaging.