Review ArticleContinuing Education

Technical Considerations in Brain Amyloid PET Imaging with 18F-Florbetapir

LisaAnn Trembath, Maureen Newell and Michael D. Devous
Journal of Nuclear Medicine Technology September 2015, 43 (3) 175-184; DOI: https://doi.org/10.2967/jnmt.115.156679

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    (A) Top row of images demonstrates proper canthomeatal positioning on left and head pitched too far forward on right. In middle row are corresponding axial projections, with standard appearance on left and nonstandard appearance on right, with frontal lobes prominent and occipital lobes just becoming visible. Bottom two images demonstrate proper coronal positioning (left), and right image shows prominent roll to left. (Courtesy of Avid Radiopharmaceuticals.) (B) Volunteer properly positioned in head holder (GE Healthcare) using laser system, cushions, chin strap, and forehead strap. (Courtesy of Desert Advanced [RadNet Imaging Centers], Palm Springs, California.)

  • FIGURE 2.
    FIGURE 2.

    Ten-minute dynamic PET acquisition, with frame 1 at top and frame 2 at bottom. Frame 2 is representative of subject motion, most notably yaw and roll. Dashed line indicates degree of motion between frames. Arrows indicate image blurring. (Courtesy of Avid Radiopharmaceuticals.)

  • FIGURE 3.
    FIGURE 3.

    Representative amyloid-negative (left) and amyloid-positive (right) transaxial slices from 18F-florbetapir PET scans. (Courtesy of Avid Radiopharmaceuticals.)

  • FIGURE 4.
    FIGURE 4.

    18F-florbetapir PET slice (left) and corresponding CT slice (right), with arrows indicating location of atrophy. (Courtesy of Avid Radiopharmaceuticals.)

  • FIGURE 5.
    FIGURE 5.

    18F-florbetapir images with poor resolution due to dose infiltration (A), imaging beyond recommended time window (B), inadequate smoothing (2 mm FWHM) (C), and scanner issue during acquisition (D). (Courtesy of Avid Radiopharmaceuticals.)

  • FIGURE 6.
    FIGURE 6.

    (A) Normal salivary gland uptake on 18F-florbetapir PET image. (B) Nonspecific bony uptake in skull and clivus bone confirmed by CT. (C) Nonspecific uptake in clivus bone. (D) Nonspecific uptake in skull. (Courtesy of Avid Radiopharmaceuticals.)

  • FIGURE 7.
    FIGURE 7.

    (A) Streak artifact on CT image (left) and PET/CT image (right) due to incomplete warm-up of CT tube. (B) Image resulting from detector block failure. (C) Image resulting from calibration error due to out-of-date normalization (left), and reprocessed image with new normalization (right). (D) Out-of-date normalization seen as streaks on non–attenuation-corrected images. (Courtesy of Avid Radiopharmaceuticals.)

Tables

  • TABLE 1

    18F-Florbetapir–Estimated Absorbed Radiation Dose (4)

    Organ or tissueμGy/MBq
    Adrenal14
    Bone
     Osteogenic cells28
     Red marrow14
    Brain10
    Breasts6
    Gallbladder wall143
    Gastrointestinal tract
     Lower large intestine wall28
     Small intestine66
     Stomach wall12
     Upper intestine wall74
    Heart wall13
    Kidneys14
    Liver64
    Lungs9
    Muscle9
    Ovaries18
    Pancreas14
    Skin6
    Spleen9
    Testes7
    Thymus7
    Thyroid7
    Urinary bladder wall27
    Uterus16
    Total body12
    Effective dose*19*
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