Brain MRI was performed with a Philips Gyroscan Intera 1.5 T Nova Dual scanner (Philips, Best, the Netherlands) in the TPC, and similarly, with a Philips Achieva 1.5 T scanner (Philips, Best, Netherlands) in the WMIC. In both centers, PET imaging was performed using an ECAT high resolution research tomograph scanner (CTI/Siemens, Knoxville, TN)10 (link) that has an intrinsic spatial resolution of approximately 2.5 mm3.11 (link) The protocols for the brain MRI and volumetric analyses and for the [11C](R)-PK11195 radioligand production and brain PET imaging with [11C](R)-PK11195 are explained in detail in appendix e-1 (links.lww.com/NXI/A37 ). The analyses of the diffusion tensor imaging (DTI) data with evaluation of global mean fractional anisotropy (FA) and mean diffusivity (MD) in the NAWM were performed according to the methodology reported earlier.12 (link)The coregistration of magnetic resonance to the PET sum images was performed using statistical parametric mapping (SPM8, version 8; Wellcome Trust Center for Neuroimaging) run on MATLAB 2011 (The MathWorks, Natick, MA). The procedures for the coregistration, performing partial volume correction, and the region of interest (ROI) definition are described in detail in appendix e-1 (links.lww.com/NXI/A37 ). The ROIs evaluated for the specific radioligand binding were as follows: T1-hypointense lesions as a single lesion mask (gadolinium-enhancing and gadolinium-negative lesion masks evaluated separately), perilesional areas with 0–3 and 3–6 mm radiuses from the T1-negative lesion masks (figure 1 ), NAWM (cerebral white matter [WM] segment − [T1 lesions + perilesional masks]), neocortex, thalamus, striatum, and cerebellum.
The regional specific binding of [11C](R)-PK11195 was evaluated as distribution volume ratios (DVRs) using the Logan method within a time interval of 20–60 minutes. For the reference region input in DVR estimation, we used clustered gray matter (GM) derived with supervised cluster algorithm approach using 4 predefined kinetic tissue classes (SuperPK software, SCA4)13 (link),14 (link) as described in our previous study.9 (link) Further parameters regarding the GM clustering are described in appendix e-1 (links.lww.com/NXI/A37 ).
The regional specific binding of [11C](R)-PK11195 was evaluated as distribution volume ratios (DVRs) using the Logan method within a time interval of 20–60 minutes. For the reference region input in DVR estimation, we used clustered gray matter (GM) derived with supervised cluster algorithm approach using 4 predefined kinetic tissue classes (SuperPK software, SCA4)13 (link),14 (link) as described in our previous study.9 (link) Further parameters regarding the GM clustering are described in appendix e-1 (