Nondisplaceable Binding Is a Potential Confounding Factor in <sup>11</sup>C-PBR28 Translocator Protein PET Studies.

Laurell, Gjertrud L; Plavén-Sigray, Pontus; Jucaite, Aurelija; Varrone, Andrea; Cosgrove, Kelly P; Svarer, Claus; Knudsen, Gitte M; Karolinska Schizophrenia Project Consortium et al. · J Nucl Med · 2021

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Abstract

The PET ligand <sup>11</sup>C-PBR28 (<i>N</i>-((2-(methoxy-<sup>11</sup>C)-phenyl)methyl)-<i>N</i>-(6-phenoxy-3-pyridinyl)acetamide) binds to the 18-kDa translocator protein (TSPO), a biomarker of glia. In clinical studies of TSPO, the ligand total distribution volume, V<sub>T</sub>, is frequently the reported outcome measure. Since V<sub>T</sub> is the sum of the ligand-specific distribution volume (V<sub>S</sub>) and the nondisplaceable-binding distribution volume (V<sub>ND</sub>), differences in V<sub>ND</sub> across subjects and groups will have an impact on V<sub>T</sub><b>Methods:</b> Here, we used a recently developed method for simultaneous estimation of V<sub>ND</sub> (SIME) to disentangle contributions from V<sub>ND</sub> and V<sub>S</sub> Data from 4 previously published <sup>11</sup>C-PBR28 PET studies were included: before and after a lipopolysaccharide challenge (8 subjects), in alcohol use disorder (14 patients, 15 controls), in first-episode psychosis (16 patients, 16 controls), and in Parkinson disease (16 patients, 16 controls). In each dataset, regional V<sub>T</sub> estimates were obtained with a standard 2-tissue-compartment model, and brain-wide V<sub>ND</sub> was estimated with SIME. V<sub>S</sub> was then calculated as V<sub>T</sub> - V<sub>ND</sub> V<sub>ND</sub> and V<sub>S</sub> were then compared across groups, within each dataset. <b>Results:</b> A lower V<sub>ND</sub> was found for individuals with alcohol-use disorder (34%, <i>P</i> = 0.00084) and Parkinson disease (34%, <i>P</i> = 0.0032) than in their corresponding controls. We found no difference in V<sub>ND</sub> between first-episode psychosis patients and their controls, and the administration of lipopolysaccharide did not change V<sub>ND</sub><b>Conclusion:</b> Our findings suggest that in TSPO PET studies, nondisplaceable binding can differ between patient groups and conditions and should therefore be considered.

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