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Zanderigo, F.

Publications and source records attributed to Zanderigo, F..

4 recordsLinked to original sources

External validation and time-stability analysis of STARE, a blood-free quantification tool for irreversible PET tracers

Rationale"Gold standard" blood-based quantification of dynamic 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) data has limited practical clinical applications due to cost and complexity of data collection and analysis. We previously presented a blood-free quantification alternative, STARE (Source-to-Target Automatic Rotating Estimation), that was validated on 18F-FDG data acquired on a ECAT EXACT HR+ scanner. Here, we extend that initial work by externally validating STARE using within-subject data acquired with both a Siemens Biograph mCT scanner and a portable Brain Biosciences CerePET scanner. MethodsPerformance was assessed by comparing regional net influx rates (Ki) estimated using STARE and the standard blood-based Patlak approach. Twenty participants underwent 60-minute 18F-FDG scans, on two different days, once in each scanner. The time-stability of both STARE- and Patlak-based Ki estimates was evaluated by applying each method to the first 20 (STARE only), 30, 40, and 50 minutes of data. ResultsSTARE demonstrated high correlation with Patlak Ki estimates across both scanner types, particularly in the Biograph mCT (r = 0.93), with lower correlation in the CerePET (r = 0.71). In the Biograph dataset, STARE provided reliable Ki estimates at all evaluated scan durations (20 minutes and above), while in the CerePET dataset, only the 50-minute duration yielded STARE Ki estimates that were not significantly different from the full 60 minutes. The Patlak approach provided Ki estimates at 40 minutes scan duration and above that did not differ from the 60-min scan results in both datasets. ConclusionSTARE is a viable, noninvasive alternative to traditional blood-based quantification of dynamic 18F-FDG PET data, facilitating shorter, blood-free acquisition. This advancement could make dynamic 18F-FDG PET imaging more accessible and comfortable for patients, promoting broader clinical adoption.

neuroscience↗

PET Imaging of the Serotonin 1A Receptor in Major Depressive Disorder: Hierarchical Multivariate Analysis of 11CWAY100635 Overcomes Outcome Measure Discrepancies

The serotonin 1A receptor has been linked to both the pathophysiology of major depressive disorder (MDD) and the antidepressant action of serotonin reuptake inhibitors. Most PET studies of the serotonin 1A receptor in MDD used the receptor antagonist radioligand, [carbonyl-11C]WAY100635; however the interpretation of the combined results has been contentious owing to reports of higher or lower binding in MDD with different outcome measures. The reasons for these divergent results originate from several sources, including properties of the radiotracer itself, which complicate its quantification and interpretation; as well as from previously reported differences between MDD and healthy volunteers in both reference tissue binding and plasma free fraction, which are typically assumed not to differ. Recently, we have developed two novel hierarchical multivariate methods which we validated for the quantification and analysis of [11C]WAY100635, which show better accuracy and inferential efficiency compared to standard analysis approaches. Importantly, these new methods should theoretically be more resilient to many of the factors thought to have caused the discrepancies observed in previous studies. We sought to apply these methods in the largest [11C]WAY100635 sample to date, consisting of 160 individuals, including 103 MDD patients, of whom 50 were not-recently-medicated and 53 were antidepressant-exposed, as well as 57 healthy volunteers. While the outcome measure discrepancies were substantial using conventional univariate analysis, our multivariate analysis techniques instead yielded highly consistent results across PET outcome measures and across pharmacokinetic models, with all approaches showing higher serotonin 1A autoreceptor binding potential in the raphe nuclei of not-recently-medicated MDD patients relative to both healthy volunteers and antidepressant-exposed MDD patients. Moreover, with the additional precision of estimates afforded by this approach, we can show that while binding is also higher in projection areas in this group, these group differences are approximately half of those in the raphe nuclei, which are statistically distinguishable from one another. These results are consistent with the biological role of the serotonin 1A autoreceptor in the raphe nuclei in regulating serotonin neuron firing and release, and with preclinical and clinical evidence of deficient serotonin activity in MDD due to over expression of autoreceptors resulting from genetic and/or epigenetic effects. These results are also consistent with downregulation of autoreceptors as a mechanism of action of selective serotonin reuptake inhibitors. In summary, the results using multivariate analysis approaches therefore demonstrate both face and convergent validity, and may serve to provide a resolution and consensus interpretation for the disparate results of previous studies examining the serotonin 1A receptor in MDD.

neuroscience↗

Source-to-Target Automatic Rotating Estimation (STARE) -- A publicly-available, blood-free quantification approach for PET tracers with irreversible kinetics: Theoretical framework and validation for FDG

IntroductionFull quantification of positron emission tomography (PET) data requires an input function. This generally means arterial blood sampling, which is invasive, labor-intensive and burdensome. There is no current, standardized method to fully quantify PET radiotracers with irreversible kinetics in the absence of blood data. Here, we present Source-to-Target Automatic Rotating Estimation (STARE), a novel, data-driven approach to quantify the net influx rate (Ki) of irreversible PET radiotracers, that requires only individual-level PET data and no blood data. We validate STARE with [18F]FDG PET and assess its performance using simulations. MethodsSTARE builds upon a source-to-target tissue model, where the tracer time activity curves (TACs) in multiple "target" regions are expressed at once as a function of a "source" region, based on the two-tissue irreversible compartment model, and separates target region Ki from source Ki by fitting the source-to-target model across all target regions simultaneously. To ensure identifiability, data-driven, subject-specific anchoring is used in the STARE minimization, which takes advantage of the PET signal in a vasculature cluster in the FOV that is automatically extracted and partial volume-corrected. To avoid the need for any a priori determination of a single source region, each of the considered regions acts in turn as the source, and a final Ki is estimated in each region by averaging the estimates obtained in each source rotation. ResultsIn a large dataset of [18F]FDG human scans (N=69), STARE Ki estimates were in good agreement with corresponding arterial blood-based estimates (regression slope=0.88, r=0.80), and were precisely estimated, as assessed by comparing STARE Ki estimates across several runs of the algorithm (coefficient of variation across runs=6.74 {+/-} 2.48%). In simulations, STARE Ki estimates were largely robust to factors that influence the individualized anchoring used within its algorithm. ConclusionThrough simulations and application to [18F]FDG PET data, feasibility is demonstrated for STARE blood-free, data-driven quantification of Ki. Future work will include applying STARE to PET data obtained with a portable PET camera and to other irreversible radiotracers.

molecular biology↗

Accuracy and reliability of PBR28 specific binding estimated without the use of a reference region

[11C]PBR28 is a positron emission tomography radioligand used to estimate the expression of 18kDa translocator protein (TSPO). TSPO is expressed on glial cells and can function as a marker for immune activation. Since TSPO is expressed throughout the brain, no true reference region exists. For this reason, an arterial input function is required for accurate quantification of [11C]PBR28 binding and the most common outcome measure is the total distribution volume (VT). Notably, VT reflects both specific binding and non-displaceable binding (VND). Therefore, estimates of specific binding, such as binding potentials (e.g., BPND) and specific distribution volume (VS) should theoretically be more sensitive to underlying differences in TSPO expression. It is unknown, however, if unbiased and accurate estimates of these measures are obtainable for [11C]PBR28.\n\nThe Simultaneous Estimation (SIME) method uses time-activity-curves from multiple brain regions with the aim to obtain a brain-wide estimate of VND, which can subsequently be used to improve the estimation of BPND and VS. In this study we evaluated the accuracy of SIME-derived VND, and the reliability of resulting estimates of specific binding for [11C]PBR28, using a combination of simulation experiments and in vivo studies in healthy humans.\n\nThe simulation experiments showed that VND values estimated using SIME were both precise and accurate. Data from a pharmacological competition challenge showed that SIME provided VND values that were on average 19% lower than those obtained using the Lassen plot, but similar to values obtained using the Likelihood-Estimation of Occupancy technique. Test-retest data showed that SIME-derived VS values exhibited good reliability and precision, while larger variability was observed in SIME-derived BPND values.\n\nThe results support the use of SIME for quantifying specific binding of [11C]PB28, and suggest that VS can be used in preference to, or as a complement to the conventional outcome measure VT. Additional studies in patient cohorts are warranted.

neuroscience↗