Effects of different reference brain regions on the SUV ratio of 18F-Florzolotau PET images in Alzheimer's disease
Objective To compare the effects of different reference brain regions on the semi-quanti-tative SUV ratio(SUVR)of 18F-Florzolotau PET images of Alzheimer's disease(AD).Methods The 18F-Florzolotau PET images of 28(13 males,15 females,age(57.3±9.5)years)normal controls(NC),19 patients(4 males,15 females,age(73.3±7.3)years)with β-amyloid(Aβ)-positive mild cognitive im-pairment(MCI)and 40 patients(19 males,21 females,age(61.9±9.1)years)with AD were collected from Huashan Hospital,Fudan University between November 2018 and July 2020.Six semi-quantitative ref-erence brain regions were defined,including whole cerebellum(WC),cerebellar gray matter(GM),cere-bellar white matter(WM),parametric estimation of reference signal intensity(PERSI),WC after partial volume correction(WC_pvc),cerebellar GM after partial volume correction(GM_pvc).SUVR was calcu-lated for 14 ROIs,which included the whole brain defined by the automated anatomical labeling(AAL)template,fusiform,inferior temporal,lingual,middle temporal,occipital,parahippocampal,parietal,pos-terior cingulate,precuneus defined by the AAL template,and Meta ROI composed of the above brain re-gions,and braak_Ⅰ-Ⅱ,braak_Ⅲ-Ⅳ,braak_Ⅴ-Ⅵ defined by the Desikan Killiany template.AUC was used to evaluate the classification ability of SUVR,and the correlation between SUVR and clinical scale scores were assessed by Spearman rank correlation analysis.Results The SUVRs of most brain regions showed a steady upward trend in the AD disease spectrum.In the classification task of NC and MCI,the over-all performance of SUVR based on WC_pvc was relatively optimal(AUCs:0.975-1.000).In the classifica-tion task of NC and AD,SUVRs of 10 ROIs based on the WC_pvc method showed the relatively best per-formance(AUCs:0.976-1.000).The correlation between SUVR of fusiform based on cerebellar WM and mini-mental state examination(MMSE)score was the strongest(rs=-0.72,P＜0.001),and the SUVR of precuneus based on WC_pvc showed the strongest correlation with clinical dementia rating(CDR)score(rs=0.78,P＜0.001).Conclusion The SUVR based on WC_pvc method performs well in classification and correlation tasks,and is recommended to be used in semi-quantification of 18F-Florzolotau PET images of AD.
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