Publications Repository - Helmholtz-Zentrum Dresden-Rossendorf

Objectives: Nicotinic α4β2* acetylcholine receptors (nAChR) are an important target for diagnostic neuroimaging because of their involvement e.g. in Alzheimer's and Parkinson's diseases, and nicotine addiction. The development of new PET-tracers for these receptors is an active field of research. Here we present the PET quantification of the new nAChR-ligand (+)-[18F]Flubatine, an enantiomer of (-)-[18F]Flubatine, also known as (-)-[18F]NCFHEB, which is already used for clinical PET imaging of nAChRs.

Methods: After intravenous administration of 284.1±13.2 MBq (+)-[18F]Flubatine PET brain recordings were performed in 11 healthy non-smoking subjects (age 66.6±4.4 years) using an ECAT EXACT HR+ system in 3D-acquisition mode. 41 frames were acquired from 0-270 min post injection and motion corrected with SPM2. Kinetic modeling using 1- and 2-tissue compartment models (1TCM, 2TCM) with arterial input-function was applied to the volume of interest (VOI) based tissue time-activity curves (TACs) generated for 36 brain regions (anatomically defined via MRI co-registration). Time ranges from 0 to 90 and 0 to 270 min were investigated. Model-based receptor parameter was the total distribution volume VT (ml/cm-3). Metabolites in plasma were measured by radioactivity HPLC and the free fraction of (+)-[18F]Flubatine in plasma was determined by ultracentrifugation.

Results: The tracer showed high stability in vivo with more than 97% remaining as untransformed parent compound at 90 and 270 min. The free fraction in plasma was high and showed only small interindividual variations (0.86±0.02, n=11). Given the negligible amounts of metabolites present in plasma the arterial input function was not corrected for metabolites.
TACs of all 36 regions could be described with the 1- or 2TCM. VT in all cortical regions could be reliably estimated from 90 min PET data. VT increased with receptor density as expected. Using the 2TCM and 270 min PET-data: CC (VT: 7.9±1.5, n=11), frontal cortex (10.8±1.2), pons (16.3±3.1), thalamus (41.3±8.7). For 90 min PET data the distribution volumes were very similar: CC (VT: 7.9±1.3), frontal cortex (10.3±1.4), pons (15.4±3.0), thalamus (41.0±9.0). The distribution volumes computed with the 1TCM were comparable to the results of the 2TCM: Frontal cortex (10.9±1.3, 270 min) and (10.2±1.4, 90 min).
The previously investigated enantiomer (-)-[18F]Flubatine showed very similar VT in cortical structures e.g., frontal (10.4±1.3, n=12) but lower VT in pons (12.4±1.9) and especially thalamus (27.6±4.2) (2TCM, 90 min; Sabri et al., 2015).

Conclusions: (+)-[18F]Flubatine has an optimal metabolic profile. The amount of metabolites is very low and no metabolite correction has to be applied to the arterial input function. The high VT values in subcortical structures are favorable. Receptor parameters can be estimated with a 1- or 2TCM from 90 min PET-data. If a model derived receptor parameter is used in a classification problem, e.g., distinguishing patients with Alzheimer’s disease from healthy controls the bias-variance tradeoff problem associated with the simpler 1TCM (higher bias) and the more complex 2TCM (higher variance) has to be solved. The final decision which model should be used will be made on the basis of the PET-data of both groups.

Reference: Sabri O et al. (2015) Neuroimage 118:199-208

Figure Legend: 2TCM fits (270 min) in 8 brain regions. Abscissa: Time in min, ordinate: Activity (kBq/cm3). Computed total tracer amount in tissue is presented but also the tracer amount in the non-displaceable and specific tissue compartment, the total distribution volume V and influx rate constant K1.