Visualising Neuroinflammation in Post-Stroke Patients: A Comparative PET Study with the TSPO Molecular Imaging Biomarkers [11C]PK11195 and [11C]vinpocetine

Balazs      Gulyas; Miklos      Toth; Adam      Vas; Evgeni      Shchukin; Konstantinos      Kostulas; Jan      Hillert; Christer      Halldin

Abstract

With the main objective of comparing the prospective diagnostic power of two ¹¹C-labelled molecular imaging biomarkers with affinity for TSPO and used for the visualisation of activated microglia after a stroke, we measured with positron emission tomography (PET) in four post-stroke patients the regional brain uptake and binding potential of [¹¹C]vinpocetine and [¹¹C]PK11195. Percentage standard uptake values (%SUV) and binding potential (BP_ND) were used as outcome measures. The total peak brain uptake value and average global brain uptake value were higher for [¹¹C]vinpocetine than for [¹¹C]PK11195. The regional %SUV values were significantly higher for [¹¹C]vinpocetine than for [¹¹C]PK11195 in the hemispheres as well as in almost all standard brain regions. The %SUV values of [¹¹C]vinpocetine were higher in the peri-infarct zone than in the ischaemic core, however, the difference did not prove to be significant. There was basically no difference in %SUV values between the ischaemic core and the peri-infarct zone for [¹¹C]PK11195. The BP_ND values for [¹¹C]vinpocetine were higher in all standard regions than those for [¹¹C]PK11195, but the difference was not significant between them. The BP_ND values of [¹¹C]vinpocetine were higher in the peri-infarct zone than in the ischaemic core, however, the difference did not prove to be significant. A comparative analysis of the two ligands indicates that [¹¹C]vinpocetine shows a number of favourable characteristics over [¹¹C]PK11195, but to demonstrate that it may serve as a prospective molecular imaging biomarker of microglia activation in post-stroke patients, further studies are required.