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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-02-2020 | Magnetic Resonance Imaging | Original Article

[¹⁸F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis

Authors: Antonio Carotenuto, Beniamino Giordano, George Dervenoulas, Heather Wilson, Mattia Veronese, Zachary Chappell, Sotirios Polychronis, Gennaro Pagano, Jane Mackewn, Federico E. Turkheimer, Steven C. R. Williams, Alexander Hammers, Eli Silber, Peter Brex, Marios Politis

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2020

Abstract

Purpose

We evaluated myelin changes throughout the central nervous system in Multiple Sclerosis (MS) patients by using hybrid [¹⁸F]florbetapir PET-MR imaging.

Methods

We included 18 relapsing-remitting MS patients and 12 healthy controls. Each subject performed a hybrid [¹⁸F]florbetapir PET-MR and both a clinical and cognitive assessment. [¹⁸F]florbetapir binding was measured as distribution volume ratio (DVR), through the Logan graphical reference method and the supervised cluster analysis to extract a reference region, and standard uptake value (SUV) in the 70–90 min interval after injection. The two quantification approaches were compared. We also evaluated changes in the measures derived from diffusion tensor imaging and arterial spin labeling.

Results

[¹⁸F]florbetapir DVRs decreased from normal-appearing white matter to the centre of T2 lesion (P < 0.001), correlated with fractional anisotropy and with mean, axial and radial diffusivity within T2 lesions (coeff. = −0.15, P < 0.001, coeff. = −0.12, P < 0.001 and coeff. = −0.16, P < 0.001, respectively). Cerebral blood flow was reduced in white matter damaged areas compared to white matter in healthy controls (−10.9%, P = 0.005). SUV_70–90 and DVR are equally able to discriminate between intact and damaged myelin (area under the curve 0.76 and 0.66, respectively; P = 0.26).

Conclusion

Our findings demonstrate that [¹⁸F]florbetapir PET imaging can measure in-vivo myelin damage in patients with MS. Demyelination in MS is not restricted to lesions detected through conventional MRI but also involves the normal appearing white matter. Although longitudinal studies are needed, [¹⁸F]florbetapir PET imaging may have a role in clinical settings in the management of MS patients.

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Title: [18F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis
Authors: Antonio Carotenuto
Beniamino Giordano
George Dervenoulas
Heather Wilson
Mattia Veronese
Zachary Chappell
Sotirios Polychronis
Gennaro Pagano
Jane Mackewn
Federico E. Turkheimer
Steven C. R. Williams
Alexander Hammers
Eli Silber
Peter Brex
Marios Politis
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Multiple Sclerosis
Positron Emission Tomography
Pathology
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04533-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

[¹⁸F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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