Amyloid PET imaging in multiple sclerosis: an (18)F-florbetaben study
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Published on: February 28, 2021
Jordi A Matías-Guiu1, María Nieves Cabrera-Martín2, Jorge Matías-Guiu3
1Department of Neurology, Hospital Clínico San Carlos. San Carlos Institute for Health Research (IdISSC), Universidad Complutense de Madrid, Calle Profesor Martín Lagos, S/N, Madrid, 28040, Spain. jordimatiasguiu@hotmail.com.
Background:
Positron emission tomography (PET) images with amyloid tracers show normal uptake in healthy white matter, which suggests that amyloid tracers are potentially useful for studying such white matter diseases as multiple sclerosis (MS).
Methods:
Twelve patients diagnosed with MS (5 with RRMS, 5 with SPMS, and 2 with PPMS) and 3 healthy controls underwent studies with MRI and (18)F-florbetaben-PET imaging. Images were preprocessed using Statistical Parametric Mapping software. We analysed (18)F-florbetaben uptake in demyelinating plaques (appearing as hyperintense lesions in FLAIR sequences), in normal-appearing white matter, and in grey matter.
Results:
Mean standardized uptake value relative to cerebellum was higher in normally appearing white matter (NAWM) (1.51 ± 0.12) than in damaged white matter (DWM) (1.24 ± 0.12; P = .002). Mean percentage of change between NAWM and DWM was -17.56% ± 6.22%. This percentage of change correlated negatively with EDSS scores (r = -0.61, p < .05) and with age (r = -0.83, p < 0.01). Progressive forms of MS showed a more pronounced reduction of the uptake in DWM in comparison to relapsing-remitting form.
Conclusions:
Uptake of (18)F-florbetaben in damaged white matter is lower than that occurring in normally-appearing white matter. These findings indicate that amyloid tracers may be useful in studies of MS, although further research is needed to evaluate the utility of amyloid-PET in monitoring MS progression.
Insights
Amyloid tracer uptake is lower in damaged white matter than normal-appearing white matter in multiple sclerosis (MS) patients. This finding suggests amyloid-PET may aid in studying MS progression.
Area of Science:
- Neuroimaging
- Nuclear Medicine
- Neurology
Background:
- Amyloid tracers show normal uptake in healthy white matter.
- This suggests potential utility for studying white matter diseases like multiple sclerosis (MS).
Purpose of the Study:
- To investigate (18)F-florbetaben uptake in MS patients using PET imaging.
- To compare tracer uptake in normal-appearing white matter (NAWM), damaged white matter (DWM), and grey matter.
Main Methods:
- 12 MS patients and 3 healthy controls underwent MRI and (18)F-florbetaben-PET scans.
- Images were analyzed using Statistical Parametric Mapping.
- Uptake was measured in plaques, NAWM, and grey matter.
Main Results:
- (18)F-florbetaben uptake was significantly lower in DWM (1.24 ± 0.12) compared to NAWM (1.51 ± 0.12).
- The reduction in uptake in DWM correlated negatively with disease severity (EDSS scores) and age.
- Progressive MS forms showed a more pronounced reduction in DWM uptake than relapsing-remitting MS.
Conclusions:
- (18)F-florbetaben uptake is reduced in the damaged white matter of MS patients.
- Amyloid-PET imaging shows promise for studying MS.
- Further research is needed to confirm its utility in monitoring MS progression.
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