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A hybrid [18F]florbetapir-PET/MR imaging study to assess in vivo demyelination in multiple sclerosis.
Author(s): ,
A. Carotenuto
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom; Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Federico II University, Naples, Italy
,
B. Giordano
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom
,
G. Dervenoulas
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom
,
H. Wilson
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom
,
M. Veronese
Affiliations:
Department of Neuroimaging, King`s College London
,
Z. Chappell
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom
,
S. Polychronis
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom
,
G. Pagano
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom
,
J. MacKewn
Affiliations:
School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London & Guy’s and St Thomas’ PET Centre
,
F.E. Turkheimer
Affiliations:
Department of Neuroimaging, King`s College London
,
S.C.R. Williams
Affiliations:
Institute of Psychiatry, Psychology and Neuroscience, King’s College London
,
A. Hammers
Affiliations:
School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London & Guy’s and St Thomas’ PET Centre
,
E. Silber
Affiliations:
Department of Neurology, King`s College Hospital NHS Foundation Trust, London, United Kingdom
,
P.A. Brex
Affiliations:
Department of Neurology, King`s College Hospital NHS Foundation Trust, London, United Kingdom
M. Politis
Affiliations:
Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King’s College London, London, United Kingdom
ECTRIMS Online Library. Carotenuto A. Oct 12, 2018; 228948; P1108
Antonio Carotenuto
Antonio Carotenuto
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Abstract: P1108

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - MRI and PET

Conventional and advanced magnetic resonance imaging (MRI) lacks specificity when assessing pathological processes in the central nervous system in Multiple Sclerosis (MS), such as inflammation, demyelination and axonal degeneration. PET imaging using amyloid-β targeting tracers is a specific measure of myelination and can show demyelination. Only one study explored the evaluation of myelin changes through [11C]PIB. However, carbon-labelled tracers have limited clinical applicability for their short half-life.
We evaluated myelin changes by using hybrid [18F]florbetapir PET-MR imaging, including diffusion tensor imaging and arterial spin labeling, in 18 relapsing-remitting MS patients and 12 healthy controls. [18F]florbetapir binding was measured as Distribution volume ratio (DVR) and standard uptake value (SUV30-50).
SUV30-50 and DVR are equally able to discriminate between normal appearing white matter and T2 lesions (area under the curve 0.76 and 0.66, respectively; P=0.26). [18F]florbetapir DVRs was not different between healthy controls and patients' normal-appearing white matter. However, it However, it was reduced in the outer T2 perilesional layer (8 - 4 mm) (-6.3%; P=0.004), in the inner T2 perilesional layer (4 - 0 mm) (-8.3%; P< 0.001). [18F]florbetapir DVR within T2 lesions positively correlated with fractional anisotropy (coeff.= 0.47, P< 0.001) and negatively correlated with mean, axial and radial diffusivity within T2 lesions (coeff. < -0.12, all P< 0.001). Cerebral blood flow was reduced in white matter damaged areas compared to white matter in healthy controls (-10.9%, P=0.005).
Overall, [18F]florbetapir PET imaging can measure in-vivo myelin integrity. Demyelination in MS is not restricted to lesions detected through conventional MRI but also involves the normal appearing white matter. Compared to advanced MRI techniques, which are sensitive to myelin water content, [18F]florbetapir PET imaging provides additional and specific information on demyelination,. [18F]florbetapir PET imaging might, therefore, be extremely helpful in clinical settings when assessing treatment efficacy and might be also used as an endpoint for MS clinical trials.
Disclosure: Antonio Carotenuto, Beniamino Giordano, George Dervenoulas, Heather Wilson, Mattia Veronese, Zachary Chappell, Sotirios Polychronis, Gennaro Pagano, Jane MacKewn, Federico E. Turkheimer, Steven C.R. Williams and Alexander Hammers declare no potential conflicts of interest with respect to the research, authorship and/or publication of this abstract. Dr Eli Silber and Peter Brex received travel funding, research support and lecture from Biogen. Dr. Eli silber is the principal investigator and Dr. Peter A Brex is the sub-investigator for the anti-lingo study sponsored by Biogen. Professor Marios Politis' research is supported by Parkinson's UK, Lily and Edmond J. Safra Foundation, Michael J Fox Foundation (MJFF) for Parkinson's research, and CHDI Foundation.
Funding: This work is supported by the Wellcome EPSRC Centre for Medical Engineering at King's College London (WT 203148/Z/16/Z) and the Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust.

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