Research ArticleClinical Investigation

Improved Correlation of 18F-Flortaucipir PET SUVRs and Clinical Stages in the Alzheimer Disease Continuum with the MUBADA/PERSI-Based Analysis

Yasuhiko Ikari, Go Akamatsu, Keiichi Matsumoto, Tomohiko Yamane, Michio Senda, Kazuki Fukuchi and AMED Preclinical AD Study Investigators, and Alzheimer’s Disease Neuroimaging Initiative Investigators
Journal of Nuclear Medicine Technology April 2024, jnmt.123.267113; DOI: https://doi.org/10.2967/jnmt.123.267113

Article Figures & Data

Figures

  • Figure
  • FIGURE 1.
    FIGURE 1.

    Scheme of SUVR measurement methods: MUBADA/PERSI method (A) and tau meta-VOI/CGM method (B). MNI = Montreal Neurological Institute; WM = white matter.

  • FIGURE 2.
    FIGURE 2.

    Box plots of SUVR for each clinical category calculated with MUBADA/PERSI method and tau meta-VOI/CGM method. Combined data include 91 ADNI3 subjects and 15 AMED-PRE subjects (A), and separate analyses for ADNI3 data (B) and AMED-PRE data (C) are also shown.*Significant difference between 2 categories (P < 0.05).

  • FIGURE 3.
    FIGURE 3.

    Typical 18F-flortaucipir PET images in each clinical category. Numbers in each image indicate SUVRs computed with MUBADA/PERSI method (upper number) and with tau meta-VOI/CGM method (lower number). Reference value for color scale was defined by PERSI.

  • FIGURE 4.
    FIGURE 4.

    Histogram of white matter voxel radioactivity (kBq/mL) and process of extracting PERSI reference in 2 MCI[A+] cases (A and B). White matter histogram (WM hist) is fitted with 2 gaussian curves (G1 and G2), of which G2 corresponds to voxels with abnormal 18F-flortaucipir accumulation, if any, and spillover. Red rectangle indicates selected range derived from G1 to define reference white matter image, which is presented together with original PET image of same slice. MUBADA/PERSI SUVR is 1.16 (A) and 1.71 (B).

  • FIGURE 5.
    FIGURE 5.

    VOI setting by MUBADA/PERSI and tau meta-VOI/CGM methods in representative late-MCI case. MUBADA/PERSI SUVR is 1.16, and tau meta-VOI/CGM SUVR is 1.46.

Tables

  • TABLE 1.

    Demographics of Subjects Analyzed in This Study

    DatabaseCategorynAge (y)Clinical dementia ratingMini Mental State ExaminationAmyloid
    ADNI3 (n = 91)Normal2368–85027–30−
    Pre-AD2371–85024–30+
    MCI[A−]2365–820.525–30−
    MCI[A+]2265–850.524–30+
    AMED-PRE (n = 15)Normal965–80025–29−
    Pre-AD172029+
    MCI[A−]275–820.528–29−
    MCI[A+]373–840.526–28+
  • TABLE 2.

    PET Scanner Models Used to Acquire 18F-Flortaucipir PET Images

    ADNI3AMED-PRE
    CategoryNormalPRE-ADMCI[A−]MCI[A+]NormalPRE-ADMCI[A−]MCI[A+]
    GE Discovery 690/7104312
    GE Discovery MI2
    GE Discovery MI DR11
    GE Discovery ST2111
    GE Discovery STE1362
    Siemens Biograph mCT3355
    Siemens Biograph TruePoint66221
    Siemens Biograph Vision1
    Philips Gemini TF2424
    Philips Ingenuity5243
    Philips Vereos1
    Shimadzu Eminence GX8123
  • TABLE 3.

    Analysis Methods

    RegionParameterMUBADA/PERSITau meta-VOI/CGM
    TargetVOI nameMUBADA VOITau meta-VOI
    Image spaceMontreal Neurologic Institute spaceIndividual’s space
    Volume (cm3)1,306.363.7 ± 8.4*
    MethodStatistically derived area with MUBADA analysisAnatomically derived area with FreeSurfer
    AnatomicPosterior temporal, occipital, parietal, part of frontalAmygdala, entorhinal, fusiform, inferior temporal, middle temporal
    ReferenceVOI namePERSI VOICGM VOI
    Image spaceMontreal Neurologic Institute spaceIndividual’s space
    Volume (cm3)403.8 ± 50.6*103.9 ± 10.6*
    MethodProbabilistically derived area with PERSI analysis, individuallyAnatomically derived area with FreeSurfer
    AnatomicWhite matterCGM

    • ↵* VOI volume: mean ± SD [cm3] of each analysis.

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