Reliability of a simple non-invasive method for the evaluation of 5-HT2 receptors using [18F]-setoperone PET imaging

Position emission tomography (PET) imaging of 5-HT2 receptors can be potentially very useful in investigating neuropsychiatric disorders and their pharmacological treatments. [18F]-setoperone, a PET radio-ligand, has been shown to be useful for the delineation of 5-HT2 receptors in the cortex. However, there is no available data regarding the scan-rescan reliability of this technique. The purpose of this study was to assess the reliability of the [18F]-setoperone PET technique for assessing the binding potential (Bmax/ Kd) for 5-HT2 receptors. Ten healthy subjects had two [18F]-setoperone PET scans on two separate occasions 6-21 days apart. The average difference in the 5-HT2 binding potential (BP) as measured on the two occasions in the prefrontal, temporal, parietal and occipital region was between 5 and 7%. Thus 5-HT2 BP can be measured with a high reliability using a non-invasive technique that uses the cerebellum as a reference region. A power analysis based on the reliability data suggests that this technique can be used to detect within-subject differences of 10% or more, and between-group differences of 25% or more, with a reasonable number of subjects. It is concluded that [18F]-setoperone can be routinely produced and reliably used for the PET imaging of 5-HT2 receptors in clinical situations.