PMC6688244_01
Serial transverse brain sections from (A) structural MRI, (B) NeuroReader segmentation, (C) [18F]AV-1451 PET, (D) [11C]PiB PET, and (E) [18F]FDG PET for Patient #1. The color bar shows uptake in standardized uptake value ratios (SUVR) with the cerebellar cortex as reference. (A,B) The MR image demonstrates evidence of decreased hippocampal volume. Occipital lobe volumes were normal. (C) The [18F]AV-1451 PET scan shows broad areas of abnormal intensely increased uptake in the cuneus (FreeSurfer mean [FS] SUVR: 2.39) and lateral occipital regions (FS SUVR: 2.28). There is also abnormally increased uptake in the superior parietal (FS SUVR: 2.19), inferior lateral temporal (FS SUVR: 1.79), and entorhinal brain regions (FS SUVR: 1.72). (D) The [11C]PiB PET scan demonstrates abnormally increased uptake in the temporal, parietal, and frontal lobes, as well as the precuneus, in a pattern characteristic of AD. Note that, by comparison, the occipital lobes have relatively less abnormal uptake. (E) The [18F]FDG scan shows abnormally decreased uptake in the posterior brain regions. The degree of asymmetry is much lower in the left posterior temporoparietal brain region, also a pattern characteristic of AD.
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F1
MRI and PET imaging results are shown in Figure 1.
PMC6688244_02
Serial transverse brain sections from (A) structural MRI, (B) NeuroReader segmentation, (C) [18F]AV-1451 PET, (D) [11C]PiB PET, and (E) [18F]FDG PET for Patient #2. (A,B) Quantitative analysis of the MRI scan demonstrated normal volumes. (C) The [18F]AV-1451 PET scan is most significant for demonstrating abnormal intensely increased symmetric uptake in the precuneus (FreeSurfer mean [FS] SUVR: 2.97), superior parietal (FS SUVR: 2.86), and lateral occipital regions (FS SUVR: 2.76). There is also abnormally increased uptake in the lateral inferior temporal (FS SUVR: 2.47), entorhinal (FS SUVR: 2.13), lateral orbitofrontal (FS SUVR: 1.78), and superior frontal (FS SUVR: 1.67) regions. (D) The [11C]PiB PET scan demonstrates significant abnormally increased uptake in parietal, temporal and frontal lobes, as in Patient #1, demonstrating a pattern characteristic of AD. Note there is negligible accumulation in the occipital lobes (as compared to the [18F]AV-1451 scan). (E) The [18F]FDG PET scan shows abnormally and relatively symmetric decreased uptake in the posterior temporoparietal regions of the brain, with sparing of the frontal lobes.
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F2
MRI and PET results are shown in Figure 2.
PMC6688244_03
Serial transverse brain sections from (A) structural MRI, (B) NeuroReader segmentation, and (C) [18F]AV-1451 PET scans for Control #1; and (D) structural MRI, (E) NeuroReader segmentation, and (F) [11C]PiB PET scans for Control #2. SUVR color bar scales for each PET radiotracer are identical across all patients and controls. The [18F]AV-1451 image for Control #1 shows mild basal ganglia, substantia nigra, and choroid plexus uptake that reflects a typical pattern of off-target binding. By comparison with both patients, there is negligible occipital, frontal, temporal, and parietal lobe uptake. The [11C]PiB image for Control #2 shows non-specific uptake in white matter regions, but negligible uptake throughout neocortical and subcortical gray matter.
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F3
NeuroReader segmentation, and [18F]AV-1451 SUVR images for Control #1 are presented in Figures 3A-C, respectively. Normalized MRI, NeuroReader segmentation, and [11C]PiB SUVR images for Control #2 are presented in Figures 3D-F, respectively.