Comparison of Early F-18 Florbetaben PET/CT to Tc-99m ECD SPECT Using Voxel, Regional, and Network Analysis

This study aimed to validate early-phase F-18 Florbetaben positron emission tomography (eFBB PET) as a brain perfusion test and determine the optimal reference region. A total of 27 patients with early Parkinson’s disease with ethyl cysteinate dimer single positron emission tomography (ECD SPECT) and FBB PET were included. Six reference regions, including whole brain (GN), pons, central white matter (CWM), whole cerebellum (WC), WC with brain stem (WC + B), and cerebellar gray matter (CG), were applied to obtain SUVR. Correlations of SUVRs between eFBB PET and ECD SPECT were calculated for each normalization method. Voxel-wise comparison of the two imaging studies was done with paired t-test. Pearson’s r for SUVRs were 0.791 for GN ( p  < 0.001), 0.422 for pons ( p  = 0.028), -0.005 for CWM ( p  = 0.982), 0.886 for WC ( p  < 0.001), 0.897 for WC + B ( p  < 0.001), and 0.904 for CG ( p  < 0.001), respectively. Early phase FBB PET had significantly higher voxel-wise SUVR in cerebral cortices, striatum, midbrain regions, and lower voxel-wise SUVR in white matter, concordantly in both GN and CG normalization method (FDR adjusted- p  < 0.05). Our findings suggest that eFBB PET is a reliable perfusion test based on a high correlation of SUVR with ECD SPECT. High gray-to-white matter contrast would be another advantage of eFBB PET for clinical use.