DOI: 10.1007/s00259-017-3876-0Pages: 1-11

Head to head comparison of [18F] AV-1451 and [18F] THK5351 for tau imaging in Alzheimer’s disease and frontotemporal dementia

1. Sungkyunkwan University School of Medicine, Department of Neurology, Samsung Medical Center

2. Neuroscience Center, Samsung Medical Center

3. Yonsei University College of Medicine, Department of Neurology, Gangnam Severance Hospital

4. University of Ulsan College of Medicine, Department of Nuclear Medicine, Asan Medical Center

5. Yonsei University College of Medicine, Department of Nuclear Medicine, Gangnam Severance Hospital

6. University of California, San Francisco, Memory and Aging Center

7. University of California, Berkeley, Helen Wills Neuroscience Institute

8. Sungkyunkwan University School of Medicine, Department of Nuclear Medicine, Samsung Medical Center

9. Kyung Hee University Hospital, Department of Neurology

10. Lawrence Berkeley National Laboratory, Center of Functional Imaging

11. Sungkyunkwan University, Department of Health Sciences and Technology, SAIHST

12. Sungkyunkwan University, Department of Clinical Research Design & Evaluation, SAIHST

Correspondence to:
Sang Won Seo
Tel: +82-2-3410-6147
Email: sangwonseo@empal.com

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Abstract

Purpose

Tau accumulation is a core pathologic change in various neurodegenerative diseases including Alzheimer’s disease and frontotemporal lobar degeneration-tau. Recently, tau positron emission tomography tracers such as [18F] AV-1451 and [18F] THK5351 have been developed to detect tau deposition in vivo. In the present study, we performed a head to head comparison of these two tracers in Alzheimer’s disease and frontotemporal dementia cases and aimed to investigate which tracers are better suited to image tau in these disorders.

Methods

A cross-sectional study was conducted using a hospital-based sample at a tertiary referral center. We recruited eight participants (two Alzheimer’s disease, four frontotemporal dementia and two normal controls) who underwent magnetic resonance image, amyloid positron emission tomography with [18F]-Florbetaben and tau positron emission tomography with both THK5351 and AV-1451. To measure regional AV1451 and THK5351 uptakes, we used the standardized uptake value ratios by dividing mean activity in target volume of interest by mean activity in the cerebellar hemispheric gray matter.

Results

Although THK5351 and AV-1451 uptakes were highly correlated, cortical uptake of AV-1451 was more striking in Alzheimer’s disease, while cortical uptake of THK5351 was more prominent in frontotemporal dementia. THK5351 showed higher off-target binding than AV-1451 in the white matter, midbrain, thalamus, and basal ganglia.

Conclusions

AV-1451 is more sensitive and specific to Alzheimer’s disease type tau and shows lower off-target binding, while THK5351 may mirror non-specific neurodegeneration.

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  • Accepted: Nov 3, 2017
  • Online: Nov 16, 2017

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