Quantitation for Dual Function of 18F-AV133 Imaging for Parkinson's Disease and Parkinsonism

Parkinson’s disease (PD) is the second most common disease with neurodegenerative disorder in the elderly population. There are about 4 to 6 million people affected by PD in the world, and the prevalence of PD is expected to be further increasing in the next few years. PD is a progressive and degenerative disease, causes significant motor disability, and also affects autonomic functions and cognition. The social and economic impacts of PD are growing over time, for patients, healthcare and caregivers. Therefore, the early and accurate diagnosis and treatment of PD is critical in reducing the overall cost, and can improve patients’ life quality. However, the current diagnosis for PD is mainly based on clinical symptoms, and such method lacks an accurate and reliable strength in detecting PD. In additional to PD, other parkinsonism (PM) including multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) are also with similar clinical symptoms, and thus difficult to be differentiated from PD. 18F-AV133 is a novel PET tracer for Vesicular monoamine transporter type 2 (VMAT2) imaging, and previous studies demonstrated a high sensitivity for detecting monoaminergic terminal reductions in PD patients. Our aims are to propose a novel dual scan protocol for VMAT2 imaging of PET tracer AV133, semi-automatic quantitation methods using the dual scan images, and provide dual functions (biomarkers for PD) from dual scan images of the same study, as well as investigate the dual-function imaging using AV133 vs. disease severity in PD, and application in differential diagnosis of PD and PM. The assumption of this dual scan protocol is that: early-phase images might reflect the perfusion information, in additional to the well known of late-phase images for VMAT2 distribution. Thus the dual scans from the same AV133 study can provide dual functions simultaneously. Since previous study has proved that early phase images are related to perfusion or cerebral glucose metabolism, the uptake pattern will be less sensitive to disease stage and preserve better anatomical information. Further quantitation analysis can be constructed by using this dual scan protocol. So during the proposed grant period, we will optimize the early phase imaging, and verify the dual scan protocol for AV133 using retrospective AV133 data and corresponding FDG images, build up a quantitative analysis system based on the proposed dual-scan protocol, all possibly without the need of an extra MRI or even FDG scans.

Project ID:PC10401-1141
External Project ID:MOST103-2314-B182-010-MY3