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PET amyloid ligand [11C]PIB uptake is increased in mild cognitive impairment
N M Kemppainen1, S Aalto, I A Wilson
1Turku PET Centre, University of Turku, Turku, Finland.
Background:
Patients with mild cognitive impairment (MCI) have increased risk to develop Alzheimer disease (AD). In AD increased brain amyloid burden has been demonstrated in vivo with PET using N-methyl-[(11)C]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole ([(11)C]PIB) as a tracer.
Objective:
To investigate whether patients with amnestic MCI would show increased [(11)C]PIB uptake, indicating early AD process.
Methods:
We studied 13 patients with amnestic MCI and 14 control subjects with PET using [(11)C]PIB as tracer. Parametric images were computed by calculating the region-to-cerebellum ratio in each voxel over 60 to 90 minutes. Group differences in [(11)C]PIB uptake were analyzed with statistical parametric mapping (SPM) and automated region-of-interest (ROI) analysis.
Results:
The SPM analysis showed that patients with MCI had significantly higher [(11)C]PIB uptake vs control subjects in the frontal, parietal, and lateral temporal cortices as well as in the posterior cingulate showing the most prominent differences. These results were supported by the automated ROI analysis in which MCI patients showed in comparison with healthy control subjects increased [(11)C]PIB uptake in the frontal cortex (39% increase from the control mean, p < 0.01), the posterior cingulate (39%, p < 0.01), the parietal (31%, p < 0.01) and lateral temporal (28%, p < 0.001) cortices, putamen (17%, p < 0.05), and caudate (25%, p < 0.05). Individually, in the frontal cortex and posterior cingulate, 8 of 13 patients with MCI had [(11)C]PIB uptake values above 2 SD from the control mean. MCI subjects having at least one APOE epsilon4 allele tended to have higher [(11)C]PIB uptake than MCI subjects without APOE epsilon4.
Conclusions:
At group level the elevated N-methyl-[(11)C]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole ([(11)C]PIB) uptake in patients with mild cognitive impairment (MCI) resembled that seen in Alzheimer disease (AD). At the individual level, about half of the MCI patients had [(11)C]PIB uptake in the AD range, suggestive of early AD process.
Insights
Patients with mild cognitive impairment (MCI) show increased brain amyloid plaque buildup, similar to Alzheimer's disease (AD). This suggests MCI may indicate an early stage of AD, detectable with [(11)C]PIB PET scans.
Area of Science:
- Neuroimaging
- Neurology
- Molecular Imaging
Background:
- Mild cognitive impairment (MCI) significantly increases the risk of developing Alzheimer's disease (AD).
- Elevated brain amyloid burden is a hallmark of AD, detectable in vivo using PET imaging with tracers like [(11)C]PIB.
Purpose of the Study:
- To investigate amyloid burden in amnestic MCI patients using [(11)C]PIB PET.
- To determine if increased [(11)C]PIB uptake in MCI indicates an early AD pathological process.
Main Methods:
- PET imaging with [(11)C]PIB tracer was performed on 13 amnestic MCI patients and 14 controls.
- Statistical parametric mapping (SPM) and automated region-of-interest (ROI) analysis were used to compare tracer uptake between groups.
Main Results:
- MCI patients exhibited significantly higher [(11)C]PIB uptake in frontal, parietal, temporal cortices, and posterior cingulate compared to controls.
- ROI analysis revealed increased uptake in MCI patients across multiple brain regions, including the frontal cortex (39%) and posterior cingulate (39%).
- Approximately half of MCI patients displayed [(11)C]PIB uptake in the AD range, with APOE ε4 carriers showing a trend towards higher uptake.
Conclusions:
- Elevated [(11)C]PIB uptake in MCI patients at a group level mirrors that observed in AD.
- Individual [(11)C]PIB uptake in about half of MCI patients suggests an early AD pathological process.
- [(11)C]PIB PET imaging shows potential for detecting early AD pathology in MCI.
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