PET studies were performed using a Siemens EXACT/HR whole-body positron emission tomograph (Siemens Medical Systems, Knoxville, TN). The AMT tracer was synthesized by using a high-yield procedure as outlined before [27 (link)]. The procedure for AMT-PET scanning has been described previously [21 (link), 28 (link)]. In brief, after 6 h of fasting, AMT (37 MBq/kg) was injected intravenously. At 25 min after tracer injection, a dynamic emission scan of the brain (7×5 min) was acquired. Measured attenuation correction, scatter, and decay correction was applied to all PET images. For visualization of AMT uptake, averaged activity images 30–55 min post-injection were created and converted to an AMT standardized uptake value (SUV) image. The PET image in plane resolution was 7.5 ± 0.4 mm at full-width half-maximum (FWHM) and 7.0 ± 0.5 mm FWHM in the axial direction.
Exact hr
Manufactured by Siemens
Sourced in United States, Germany
The EXACT/HR is a high-resolution analytical laboratory instrument designed for precise measurements and analysis. It features advanced technology to provide accurate and reliable data. The core function of the EXACT/HR is to enable precise and detailed analysis across a wide range of applications.
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9 protocols using exact hr
1
PET Imaging of AMT Tracer Uptake
2
Multimodal Imaging of Amyloid Burden
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Multimodal Imaging for Glioma Resection Evaluation
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The PET studies were performed prior to and after (mean, 3±2 days; median, 2 days) the resection using a dedicated ECAT EXACT HR+ PET scanner (Siemens CTI, Knoxville, TN, USA) in 3-D mode. 182±34 MBq of [18F]FET were intravenously injected. Patients were positioned supine using a low-attenuation head holder. Static acquisitions from 20–40 min p.i. followed by a 7 minute transmission scan using [68Ga]/[68Ge] rod sources were performed. Images were reconstructed using 3D filtered backprojection with a Hann filter (cut off frequency 0.34) and corrected for attenuation, scatter and randoms.
MRI was performed on a Philips Achieva 3.0 MR-tomograph (Philips Healthcare, Amsterdam, The Netherlands). Patients were positioned supine. Pre-operatively, axial T1±Gd, T2 FLAIR, T2*, DWI with ADC map and 3D T1+Gd for navigation sequences were acquired.
After resection (mean; 1±1 day; median; 1 day), axial T1±Gd and subtraction, T2 FLAIR and T2* sequences were obtained. Follow-up MRI and/or PET scans were performed at intervals of three months or at clinical suspicion of tumor recurrence/progression.
MRI was performed on a Philips Achieva 3.0 MR-tomograph (Philips Healthcare, Amsterdam, The Netherlands). Patients were positioned supine. Pre-operatively, axial T1±Gd, T2 FLAIR, T2*, DWI with ADC map and 3D T1+Gd for navigation sequences were acquired.
After resection (mean; 1±1 day; median; 1 day), axial T1±Gd and subtraction, T2 FLAIR and T2* sequences were obtained. Follow-up MRI and/or PET scans were performed at intervals of three months or at clinical suspicion of tumor recurrence/progression.
4
PET Imaging of Glioma Tryptophan Uptake
5
RAC PET Imaging Protocol
6
Multimodal Brain Imaging Protocol
7
Cerebral Glucose Metabolism PET Imaging
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Cerebral glucose metabolism was a secondary outcome of this study. Participants underwent the scan after a 4 h fast from food, nicotine, caffeine, medications, and alcohol (but not water). If female and of childbearing potential, a pregnancy test was given prior to these scans. If a participant was to have blood drawn (see Clinical Assessment) on the day of PET scan, this was done prior to tracer injection. A blood glucose test was administered to measure blood glucose levels and had to be ≤180 mg/dL for FDG to be injected. Images were acquired using a PET scanner (EXACT HR+, Siemens, Erlangen, Germany) in 3-dimensional mode (septa retracted) using the Alzheimer’s Disease Neuroimaging Initiative protocol [31 (link)]. Prior to the PET scan, the participant’s blood pressure and pulse were taken. Participant were positioned head first, supine with the cantho-meatal line parallel to the in-plane field of view. An intravenous catheter was placed in one arm for injection of 5.0±0.5 mCi of 18F FDG and the participant was instructed to remain awake but relaxed in a quiet room. Imaging began 30 min after injection, and the scan was acquired as six, 5 min frames with the participant positioned head first, supine with the cantho-meatal line parallel to the in-plane field of view. A 5 min transmission scan was then acquired following the emission scan.
8
CSF Aβ and Amyloid PET Imaging
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Methods for processing CSF are described in full elsewhere [24] (link). Briefly, 22 mL of CSF were removed from the L3-L4 or L4-L5 vertebral interspace for each participant. These samples were processed at the Clinical Neurochemistry Laboratory at the Sahlgrenska Academy of the University of Gothenburg, Sweden. Samples were sent in batches at two time points and analyzed using commercially available enzyme-linked immunosorbent assay methods. CSF samples were assayed for Aβ42 and Aβ40 and corrected for batch as previously described [24] (link). 128 participants in the present study had available CSF Aβ42 and/or Aβ40.
206 participants underwent 70-minute dynamic [11C]PiB positron emission tomography scans (Siemens EXACT HR+) initiated with bolus injection (nominal 555 MBq). [11C]PiB radiochemical synthesis, positron emission tomography data acquisition, image processing and quantification have been described in depth previously [25] (link). The primary measure was average cortical [11C]PiB distribution volume ratio (reference Logan graphical analysis, cerebellum gray matter reference region, = 0.149 min−1[26] , [27] (link)) across eight bilateral regions of interest (angular, anterior, and posterior cingulate, medial orbitofrontal, supramarginal, middle, and superior temporal gyri, and precuneus) [28] (link).
206 participants underwent 70-minute dynamic [11C]PiB positron emission tomography scans (Siemens EXACT HR+) initiated with bolus injection (nominal 555 MBq). [11C]PiB radiochemical synthesis, positron emission tomography data acquisition, image processing and quantification have been described in depth previously [25] (link). The primary measure was average cortical [11C]PiB distribution volume ratio (reference Logan graphical analysis, cerebellum gray matter reference region, = 0.149 min−1[26] , [27] (link)) across eight bilateral regions of interest (angular, anterior, and posterior cingulate, medial orbitofrontal, supramarginal, middle, and superior temporal gyri, and precuneus) [28] (link).
9
PET Imaging of Cardiac Radiotracer Uptake
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