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BACKGROUND AND PURPOSE: The aim of this study was to determine the diagnostic performance and safety of a new ¹8F-labeled amyloid tracer, ¹8F-FC119S. METHODS: This study prospectively recruited 105 participants, comprising 53 with Alzheimer's disease (AD) patients, 16 patients with dementia other than AD (non-AD), and 36 healthy controls (HCs). In the first screening visit, the Seoul Neuropsychological Screening Battery cognitive function test was given to the dementia group, while HC subjects completed the Korean version of the Mini Mental State Examination. Individuals underwent ¹8F-FC119S PET, ¹8F-fluorodeoxyglucose (FDG) PET, and brain MRI. The diagnostic performance of ¹8F-FC119S PET for AD was compared to a historical control (comprising previously reported and currently used amyloid-beta PET agents), ¹8F-FDG PET, and MRI. The standardized uptake value (SUV) ratio (ratio of the cerebral cortical SUV to the cerebellar SUV) was measured for each PET data set to provide semiquantitative analysis. All adverse effects during the clinical trial periods were monitored. RESULTS: Visual assessments of the ¹8F-FC119S PET data revealed a sensitivity of 92% and a specificity of 84% in detecting AD. ¹8F-FC119S PET demonstrated equivalent or better diagnostic performance for AD detection than the historical control, ¹8F-FDG PET (sensitivity of 80.0% and specificity of 76.0%), and MRI (sensitivity of 98.0% and specificity of 50.0%). The SUV ratios differed significantly between AD patients and the other groups, at 1.44±0.17 (mean±SD) for AD, 1.24±0.09 for non-AD, and 1.21±0.08 for HC. No clinically significant adverse effects occurred during the trial periods. CONCLUSIONS: ¹8F-FC119S PET provides high sensitivity and specificity in detecting AD and therefore may be considered a useful diagnostic tool for AD.
RESUMEN
OBJECTIVE: The reinforcement of the anterior cerebral artery (ACA) territory perfusion is important for the future intellectual functioning of pediatric moyamoya disease (MMD) patients. To evaluate the hemodynamic improvement of the ACA territory, bifrontal encephalogaleo-(periosteal)synangiosis [EG(P)S] combined with encephaloduroarteriosynangiosis (EDAS) was compared with EDAS alone in pediatric MMD patients using brain perfusion SPECT. METHODS: Among 36 patients (M:F = 16:20; mean age, 9.5 ± 3.0 years) who were surgically treated for MMD, EDAS was performed in 17 patients, and EDAS with bifrontal EG(P)S in 19 patients. Hemodynamic parameters consisting of basal cerebral perfusion, acetazolamide-challenge stress perfusion, and cerebrovascular reserve index were estimated using brain perfusion SPECT and probabilistic perfusion maps for the ACA and middle cerebral artery (MCA) territories. Cerebral angiography was performed to confirm revascularization. RESULTS: Both the EDAS only (p = 0.04) and EDAS with EG(P)S group (p < 0.001) had significant improvements in cerebrovascular reserve of the ipsilateral MCA territory. The EDAS with EG(P)S group had significant improvements, not only in basal perfusion of the ipsilateral ACA territory (p = 0.03) but also in the cerebrovascular reserve of the bilateral ACA territories (p < 0.01). In parallel with the hemodynamic changes assessed by brain perfusion SPECT, neovascularization was noted in the ipsilateral MCA territory in both the EDAS only and EDAS with EG(P)S group, and in the ipsilateral ACA territory in the EDAS with EG(P)S group on the postoperative cerebral angiography. CONCLUSIONS: EDAS with bifrontal EG(P)S induces significant improvements in the ACA and MCA territories, while EDAS generates significant improvements in the MCA territory only.