1. (+)-[18F]Flubatine as a novel α4β2 nicotinic acetylcholine receptor PET ligand—results of the first-in-human brain imaging application in patients with β-amyloid PET-confirmed Alzheimer’s disease and healthy controls
- Author
-
Henryk Barthel, Jörg Steinbach, Steffen Fischer, René Smits, Diego Cecchin, Osama Sabri, Bernhard Sattler, Marianne Patt, Solveig Tiepolt, Julia Luthardt, Georg-Alexander Becker, Alexander Hoepping, Gudrun Wagenknecht, Hermann-Josef Gertz, Michael Rullmann, Friedrich-Alexander Ludwig, Winnie Deuther-Conrad, Peter Brust, S Wilke, Philipp Meyer, and Swen Hesse
- Subjects
medicine.medical_specialty ,(+)-[ ,18 ,F]Flubatine [(+)-[ ,F]NCFHEB] ,Human brain ,Kinetic modeling ,PET ,α4β2 nicotinic acetylcholine receptors ,Metabolite ,Partial volume ,Neuroimaging ,Standardized uptake value ,Receptors, Nicotinic ,Ligands ,030218 nuclear medicine & medical imaging ,White matter ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Alzheimer Disease ,Internal medicine ,medicine ,Radioligand ,Humans ,Radiology, Nuclear Medicine and imaging ,ddc:610 ,Temporal cortex ,Amyloid beta-Peptides ,Aniline Compounds ,Brain ,(+)-[18F]Flubatine [(+)-[18F]NCFHEB] ,General Medicine ,Bridged Bicyclo Compounds, Heterocyclic ,Nicotinic acetylcholine receptor ,medicine.anatomical_structure ,Endocrinology ,chemistry ,Positron-Emission Tomography ,Benzamides ,Original Article ,030217 neurology & neurosurgery - Abstract
Purposes We present the first in-human brain PET imaging data of the new α4β2 nicotinic acetylcholine receptor (nAChR)–targeting radioligand (+)-[18F]Flubatine. Aims were to develop a kinetic modeling-based approach to quantify (+)-[18F]Flubatine and compare the data of healthy controls (HCs) and patients with Alzheimer’s disease (AD); to investigate the partial volume effect (PVE) on regional (+)-[18F]Flubatine binding; and whether (+)-[18F]Flubatine binding and cognitive test data respective β-amyloid radiotracer accumulation were correlated. Methods We examined 11 HCs and 9 mild AD patients. All subjects underwent neuropsychological testing and [11C]PiB PET/MRI examination. (+)-[18F]Flubatine PET data were evaluated using full kinetic modeling and regional as well as voxel-based analyses. Results With 270-min p.i., the unchanged parent compound amounted to 97 ± 2%. Adequate fits of the time-activity curves were obtained with the 1 tissue compartment model (1TCM). (+)-[18F]Flubatine distribution volume (binding) was significantly reduced in bilateral mesial temporal cortex in AD patients compared with HCs (right 10.6 ± 1.1 vs 11.6 ± 1.4, p = 0.049; left 11.0 ± 1.1 vs 12.2 ± 1.8, p = 0.046; one-sided t tests each). PVE correction increased not only (+)-[18F]Flubatine binding of approximately 15% but also standard deviation of 0.4–70%. Cognitive test data and (+)-[18F]Flubatine binding were significantly correlated in the left anterior cingulate, right posterior cingulate, and right parietal cortex (r > 0.5, p 18F]Flubatine binding and [11C]PiB standardized uptake value ratios were negatively correlated in several regions; whereas in HCs, a positive correlation between cortical (+)-[18F]Flubatine binding and [11C]PiB accumulation in the white matter was found. No adverse event related to (+)-[18F]Flubatine occurred. Conclusion (+)-[18F]Flubatine is a safe and stable PET ligand. Full kinetic modeling can be realized by 1TCM without metabolite correction. (+)-[18F]Flubatine binding affinity was high enough to detect group differences. Of interest, correlation between white matter β-amyloid PET uptake and (+)-[18F]Flubatine binding indicated an association between white matter integrity and availability of α4β2 nAChRs. Overall, (+)-[18F]Flubatine showed favorable characteristics and has therefore the potential to serve as α4β2 nAChR–targeting PET ligand in further clinical trials.
- Published
- 2020
- Full Text
- View/download PDF