Quantitative PET and Histology of Brain Biopsy Reveal Lack of Selective Pittsburgh Compound-B Binding to Intracerebral Amyloidoma

• DOI: 10.3233/jad-180316
• Publication Date: 2018-07-20T16:35:22Z
• Authors: Colin Groot; Nelleke Tolboom; Milos D. Ikonomovic; Adriaan A. Lammer...; Baayla D.C. Boon; Frederik Barkhof; Philip Scheltens; William E. Klunk; Annemieke J.M. Ro...; Rik Ossenkoppele; Bart N.M. van Ber...
• Keywords: Amyloid; positron emission tomography; Biopsy; Positron-emission-tomography; histology; case study; 03 medical and health sciences; 0302 clinical medicine; Seizures; Humans; Science & Technology; Aniline Compounds; Nervous-system; Neurosciences; Beta; Brain; Amyloidosis; Middle Aged; Magnetic Resonance Imaging; 3. Good health; Thiazoles; Positron-Emission Tomography; Peptide; Alzheimers-disease; Images; Deposits; Female; Neurosciences & Neurology; Life Sciences & Biomedicine

This single case study examines selective Pittsburgh compound-B (PiB) binding to an intracerebral light-chain amyloidoma using a 90-minute dynamic [11C]PiB-PET scan and brain biopsy tissue. Parametric non-displaceable binding potential (BPND) images showed low specific binding in the amyloidoma (BPND = 0.23), while relative tracer delivery was adequate (R1 = 0.44). Histology of the tissue revealed strong coloring with Congo-red, thioflavin-S, and X-34, indicating presence of amyloid. However, immunological staining with 6F/3D revealed absence of amyloid-β and histofluorescence of 6-CN-PiB, a highly fluorescent derivative of PiB, was at background levels. Our results suggest that PiB does not detect the atypical amyloid pathology associated with an intracerebral light-chain amyloidoma. These findings are of interest to clinicians and researchers applying [11C]PiB-PET to detect atypical forms of amyloid pathology.