Patients underwent PET imaging at Turku PET Centre, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku Turku, Finland.
Positron emission tomography with [18F]flutemetamol and [11C]PiB for in vivo detection of cerebral cortical amyloid in normal pressure hydrocephalus patients
Article first published online: 11 FEB 2013
© 2013 The Author(s) European Journal of Neurology © EFNS
European Journal of Neurology
Volume 20, Issue 7, pages 1043–1052, July 2013
How to Cite
Leinonen, V., Rinne, J. O., Virtanen, K. A., Eskola, O., Rummukainen, J., Huttunen, J., von und zu Fraunberg, M., Nerg, O., Koivisto, A. M., Rinne, J., Jääskeläinen, J. E., Buckley, C., Smith, A., Jones, P. A., Sherwin, P., Farrar, G., McLain, R., Kailajärvi, M., Heurling, K. and Grachev, I. D. (2013), Positron emission tomography with [18F]flutemetamol and [11C]PiB for in vivo detection of cerebral cortical amyloid in normal pressure hydrocephalus patients. European Journal of Neurology, 20: 1043–1052. doi: 10.1111/ene.12102
- Issue published online: 10 JUN 2013
- Article first published online: 11 FEB 2013
- Manuscript Accepted: 17 DEC 2012
- Manuscript Received: 5 NOV 2012
- GE Healthcare
- Finnish Medical Foundation
- Alzheimer's disease;
- brain amyloid-β;
- brain biopsy;
- normal pressure hydrocephalus;
- Pittsburgh compound B;
- positron emission tomography
Background and purpose
This study determined the correlation between uptake of the amyloid positron emission tomography (PET) imaging agent [18F]flutemetamol and amyloid-β measured by immunohistochemical and histochemical staining in a frontal cortical biopsy.
Fifteen patients with possible normal pressure hydrocephalus (NPH) and previous brain biopsy obtained during intracranial pressure monitoring underwent [18F]flutemetamol PET. Seven of these patients also underwent [11C] Pittsburgh compound B (PiB) PET. [18F]Flutemetamol and [11C]PiB uptake was quantified using standardized uptake value ratio (SUVR) with the cerebellar cortex as a reference region. Tissue amyloid-β was evaluated using the monoclonal antibody 4G8, Thioflavin-S and Bielschowsky silver stain.
[18F]Flutemetamol and [11C]PiB SUVRs correlated with biopsy specimen amyloid-β levels contralateral (r = 0.86, P < 0.0001; r = 0.96, P = 0.0008) and ipsilateral (r = 0.82, P = 0.0002; r = 0.87, P = 0.01) to the biopsy site. Association between cortical composite [18F]flutemetamol SUVRs and [11C]PiB SUVRs was highly significant (r = 0.97, P = 0.0003).
[18F]Flutemetamol detects brain amyloid-β in vivo with moderate to high sensitivity and high specificity. This agent, therefore, represents a valuable new tool to study and verify the presence of amyloid-β pathology, both in patients with possible NPH and among the wider population.