Binding of ¹¹C-Pittsburgh compound-B correlated with white matter injury in hypertensive small vessel disease

¹¹C-Pittsburgh compound-B (¹¹C-PIB) positron emission tomography (PET) is used to visualize and quantify amyloid deposition in the brain cortex in pathological conditions such as Alzheimer's disease (AD). Intense ¹¹C-PIB retention is also observed in the white matter (WM) of both healthy individuals and AD patients. However, the clinical implications of this retention in brain WM have not been clarified. We investigated the relationship between the extent of white matter lesions (WMLs) and the binding potential of ¹¹C-PIB (BP_ND) in the WM in patients with hypertensive small vessel disease. We further examined the relationship between the extent of WMLs and BP_ND in WML and in normal-appearing white matter (NAWM). Twenty-one hypertensive vasculopathy patients, without AD and major cerebral arterial stenosis and/or occlusion, were enrolled (9 women, 68 ± 7 years). Regions of WML and NAWM were extracted using magnetization-prepared rapid gradient-echo and fluid-attenuated inversion recovery of magnetic resonance images. Volumes of interest (VOIs) were set in the cortex-subcortex, basal ganglia, and centrum semiovale (CS). BP_ND in the cortex-subcortex, basal ganglia, CS, WML, and NAWM were estimated on ¹¹C-PIB PET using Logan graphical analysis with cerebellar regions as references. The relationships between WML volume and BP_ND in each region were examined by linear regression analysis. BP_ND was higher in the CS and basal ganglia than in the cortex-subcortex regions. WML volume had a significant inverse correlation with BP_ND in the CS (Slope = -0.0042, R² = 0.44, P < 0.01). For intra WM comparison, BP_ND in NAWM was significantly higher than that in WML. In addition, although there were no correlations between WML volume and BP_ND in WML, WML volume was significantly correlated inversely with BP_ND in NAWM (Slope = -0.0017, R² = 0.26, P = 0.02). ¹¹C-PIB could be a marker of not only cortical amyloid-β deposition but also WM injury accompanying the development of WMLs in hypertensive small vessel disease. (author)