From metabolic connectivity to molecular connectivity: application to dopaminergic pathways.

Verger, Antoine; Horowitz, Tatiana; Chawki, Mohammad B; Eusebio, Alexandre; Bordonne, Manon; Azulay, Jean-Philippe; Girard, Nadine; Guedj, Eric · Eur J Nucl Med Mol Imaging · 2020

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Abstract

This study aims to reveal the feasibility and potential of molecular connectivity based on neurotransmission in comparison with the metabolic connectivity with an application to dopaminergic pathways. For this purpose, we propose to compare the neurotransmission connectivity findings using <sup>123</sup>I-FP-CIT SPECT and <sup>18</sup>F-FDOPA PET with the metabolic connectivity findings using <sup>18</sup>F-FDG PET. <sup>18</sup>F-FDG PET and <sup>123</sup>I-FP-CIT SPECT images from 47 subjects and <sup>18</sup>F-FDOPA PET images from 177 subjects, who had no neurological or psychiatric disorders, were studied. Interregional correlation analyses were performed at the group level to determine the midbrain's connectivity via glucose metabolic rate using <sup>18</sup>F-FDG PET and via dopaminergic binding potential using <sup>123</sup>I-FP-CIT SPECT and <sup>18</sup>F-FDOPA PET. SPM-T maps of each radiotracer were generated, and masks used to highlight the significant differences obtained among the imaging modalities and targets. The three dopaminergic pathways (i.e., nigrostriatal, mesolimbic, and mesocortical) were identified by <sup>18</sup>F-FDG PET (1599 voxels, with a T<sub>max</sub> value of 12.6), <sup>123</sup>I-FP-CIT SPECT (1120 voxels, with T<sub>max</sub> value of 5.1), and <sup>18</sup>F-FDOPA PET (6054 voxels, with T<sub>max</sub> value of 11.7) for a T voxel threshold of 5.10, 2.80, and 5.10, respectively. Using the same T voxel threshold of 5.10, <sup>18</sup>F-FDOPA PET showed more specific findings than <sup>18</sup>F-FDG PET with less voxels identified outside these pathways (- 9323 voxels), whereas no significant voxels were obtained with <sup>123</sup>I-FP-CIT SPECT at this threshold. The present study illustrates the feasibility and interest in using molecular connectivity with <sup>18</sup>F-FDOPA PET for dopaminergic pathways. Such analyses could be applied to specific diseases involving the dopaminergic system.

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