Imperial College London

ProfessorRogerGunn

Faculty of MedicineDepartment of Brain Sciences

Emeritus Professor of Molecular Neuroimaging
 
 
 
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r.gunn

 
 
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Burlington DanesHammersmith Campus

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Summary

 

Publications

Publication Type
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469 results found

Bowles C, Liang C, Bentley P, Guerrero R, Gunn R, Hammers A, Dickie D, Hernandez M, Wardlaw J, Rueckert Det al., 2018, Gan augmentation: augmenting training data using generative adversarial networks

One of the biggest issues facing the use of machine learning in medical imaging is the lack of availability of large, labelled datasets. The annotation of medical images is not only expensive and time-consuming but also highly dependent on the availability of expert observers. The limited amount of training data can inhibit the performance of supervised machine learning algorithms which often need very large quantities of data on which to train to avoid overfitting. So far, much effort has been directed at extracting as much information as possible from what data is available. Generative Adversarial Networks (GANs) offer a novel way to unlock additional information from a dataset by generating synthetic samples with the appearance of real images. This paper demonstrates the feasibility of introducing GAN derived synthetic data to the training datasets in two brain segmentation tasks, leading to improvements in Dice Similarity Coefficient(DSC) of between 1 and 5 percentage points under different conditions, with the strongest effects seen fewer than ten training image stacks are available.

Working paper

Tyacke R, Myers J, Venkataraman A, Mick I, Turton S, Passchier J, Husbands S, Rabiner EA, Gunn R, Murphy P, Parker C, Nutt Det al., 2018, Evaluation of 11C-BU99008, a positron emission tomography ligand for the Imidazoline2 binding site in human brain, Journal of Nuclear Medicine, Vol: 59, Pages: 1597-1602, ISSN: 1535-5667

The imidazoline2 binding sites (I2BS), are thought to be expressed in glia, and implicated in the regulation of glial fibrillary acidic protein. A positron emission tomography (PET) ligand for this target would be important for the investigation of neurodegenerative and neuroinflammatory diseases. 11C BU99008 has previously been identified as a putative PET radioligand. Here we present the first in vivo characterisation of this PET radioligand in humans and assess its test-retest reproducibility. Methods: 14 healthy male volunteers underwent dynamic PET imaging with 11C BU99008 and arterial sampling. Six subjects were used to assess test-retest and eight were used in the pharmacological evaluation, undergoing a second, or third heterologous competition scan with the mixed I2BS/α2 adrenoceptor drug, idazoxan (n=8; 20, 40, 60 and 80 mg) and the mixed irreversible monoamine oxidase (MAO) A/B inhibitor, isocarboxazid (n=4; 50 mg), respectively. Regional time-activity data were generated from arterial plasma input functions corrected for metabolites using the most appropriate model to derive the outcome measure VT (regional total distribution volume). All image processing and kinetic analysis was performed in MIAKAT™ (www.miakat.org). Results: Brain uptake of 11C BU99008 was good with reversible kinetics and a heterogeneous distribution consistent with known I2BS expression. Model selection criteria indicated that the 2-tissue-compartment was preferred. VT estimates were high in the striatum (105±21 mL cm 3), medium in cingulate cortex (62±10 mL cm 3) and low in the cerebellum (41±7 mL cm 3). Test-retest reliability was found to be reasonable. The uptake was dose-dependently reduced by pre-treatment with idazoxan throughout the brain, with an average block across all regions of ~60% (VT≅30 mL cm 3) at the highest dose (80 mg). The median effective dose (ED50) for idazoxan was calculated as 28 mg. Uptake was not blocked by pre-treatme

Journal article

Mansur A, Newbould R, Searle GE, Redstone C, Gunn RN, Hallett WAet al., 2018, PET-MR Attenuation Correction in Dynamic Brain PET Using [C-11] Cimbi-36: A Direct Comparison With PET-CT, IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES, Vol: 2, Pages: 483-489, ISSN: 2469-7311

Journal article

Venkataraman A, Keat N, Myers J, Turton S, Mick I, Gunn R, Rabiner E, Passchier J, Parker C, Tyacke R, Nutt Det al., 2018, First evaluation of PET-based human biodistribution and radiation dosimetry of 11C-BU99008, a tracer for imaging the imidazoline2 binding site, EJNMMI Research, Vol: 8, ISSN: 2191-219X

BackgroundWe measured whole body distribution of 11C-BU99008, a new PET biomarker for non-invasive identification of the imidazoline2 binding site. The purpose of this phase I study was to evaluate the biodistribution and radiation dosimetry of 11C-BU99008 in healthy human subjects.MethodsA single bolus injection of 11C-BU99008 (296 ± 10.5 MBq) was administered to four healthy subjects who underwent whole-body PET/CT over 120 min from the cranial vertex to the mid-thigh. Volumes of interest were drawn around visually identifiable source organs to generate time-activity curves (TAC). Residence times were determined from time-activity curves. Absorbed doses to individual organs and the whole body effective dose were calculated using OLINDA/EXM 1.1 for each subject.ResultsThe highest measured activity concentration was in the kidney and spleen. The longest residence time was in the muscle at 0.100 ± 0.023 h, followed by the liver at 0.067 ± 0.015 h and lungs at 0.052 ± 0.010 h. The highest mean organ absorbed dose was within the heart wall (0.028 ± 0.002 mGy/MBq), followed by the kidneys (0.026 ± 0.005 mGy/MBq). The critical organ was the heart wall. The total mean effective dose averaged over subjects was estimated to be 0.0056 ± 0.0004 mSv/MBq for an injection of 11C-BU99008.ConclusionsThe biodistribution of 11C-BU99008 has been shown here for the first time in humans. Our dosimetry data showed the total mean effective dose over all subjects was 0.0056 ± 0.0004 mSv/MBq, which would result in a total effective dose of 1.96 mSv for a typical injection of 350 MBq of 11C-BU99008. The effective dose is not appreciably different from those obtained with other 11C tracers.

Journal article

Narayan N, Owen D, Mandhair H, Smyth E, Carlucci F, Saleem A, Gunn R, Rabiner EIA, Wells L, Dakin S, Sabokbar A, Taylor Pet al., 2018, Translocator protein as an imaging marker of macrophage and stromal activation in RA pannus, Journal of Nuclear Medicine, Vol: 59, Pages: 1125-1132, ISSN: 1535-5667

Positron Emission Tomography (PET) radioligands targeted to Translocator protein (TSPO), offer a highly sensitive and specific means of imaging joint inflammation in rheumatoid arthritis (RA). Through high expression of TSPO on activated macrophages, TSPO PET has been widely reported in several studies of RA as a means of imaging synovial macrophages in vivo. However, this premise does not take into account the ubiquitous expression of TSPO. This study aimed to investigate TSPO expression in major cellular constituents of RA pannus; monocytes, macrophages, fibroblast-like synoviocytes (FLS) and CD4+ T lymphocytes, to more accurately interpret TSPO PET signal from RA synovium. Methods: 3 RA patients and 3 healthy volunteers underwent PET both knees using the TSPO radioligand 11C-PBR28. Through synovial tissue 3H-PBR28 autoradiography and immunostaining of 6 RA patients and 6 healthy volunteers, cellular expression of TSPO in synovial tissue was evaluated. TSPO mRNA expression and 3H-PBR28 radioligand binding was assessed using in vitro monocytes, macrophages, FLS and CD4+ T-lymphocytes. Results:11C-PBR28 PET signal was significantly higher in RA compared to healthy joints (average SUV 0.82± 0.12 compared to 0.03± 0.004 respectively, p<0.01). Further, 3H-PBR28 specific binding in synovial tissue was approximately 10-fold higher in RA compared to healthy controls. Immunofluorescence revealed TSPO expression on macrophages, FLS and CD4+ T cells. In vitro study demonstrated highest TSPO mRNA expression and 3H-PBR28 specific binding, in activated FLS, non-activated and activated 'M2' reparative macrophages, with least TSPO expression in activated and non-activated CD4+ T lymphocytes. Conclusion: This study is the first evaluation of cellular TSPO expression in synovium, finding highest TSPO expression and PBR28 binding on activated synovial FLS and M2 phenotype macrophages. TSPO targeted PET may therefore have unique sensitivity to detect FLS and macropha

Journal article

Plaven-Sigray P, Schain M, Zanderigo F, Rabiner I, Gunn R, Ogden T, Cervenka Set al., 2018, Accuracy and reliability of [<sup>11</sup>C]PBR28 specific binding estimated without the use of a reference region

<jats:p>[<jats:sup>11</jats:sup>C]PBR28 is a positron emission tomography radioligand used to estimate the expression of 18kDa translocator protein (TSPO). TSPO is expressed on glial cells and can function as a marker for immune activation. Since TSPO is expressed throughout the brain, no true reference region exists. For this reason, an arterial input function is required for accurate quantification of [<jats:sup>11</jats:sup>C]PBR28 binding and the most common outcome measure is the total distribution volume (V<jats:sub>T</jats:sub>). Notably, V<jats:sub>T</jats:sub> reflects both specific binding and non-displaceable binding (V<jats:sub>ND</jats:sub>). Therefore, estimates of specific binding, such as binding potentials (e.g., BP<jats:sub>ND</jats:sub>) and specific distribution volume (V<jats:sub>S</jats:sub>) should theoretically be more sensitive to underlying differences in TSPO expression. It is unknown, however, if unbiased and accurate estimates of these measures are obtainable for [<jats:sup>11</jats:sup>C]PBR28.</jats:p><jats:p>The Simultaneous Estimation (SIME) method uses time-activity-curves from multiple brain regions with the aim to obtain a brain-wide estimate of V<jats:sub>ND</jats:sub>, which can subsequently be used to improve the estimation of BP<jats:sub>ND</jats:sub> and V<jats:sub>S</jats:sub>. In this study we evaluated the accuracy of SIME-derived V<jats:sub>ND</jats:sub>, and the reliability of resulting estimates of specific binding for [<jats:sup>11</jats:sup>C]PBR28, using a combination of simulation experiments and <jats:italic>in vivo</jats:italic> studies in healthy humans.</jats:p><jats:p>The simulation experiments showed that V<jats:sub>ND</jats:sub> values estimated using SIME were both precise and accurate. Data from a pha

Working paper

Mansur A, Comley R, Lewis Y, Middleton L, Huiban M, Guo Q, Passchier J, Tsukada H, Gunn R, Rabiner Eet al., 2018, Imaging of Mitochondrial Complex 1 with <SUP>18</SUP>F-BCPP-EF in the Healthy Human Brain, Annual Meeting of the Society-of-Nuclear-Medicine-and-Molecular-Imaging (SNMMI), Publisher: SOC NUCLEAR MEDICINE INC, ISSN: 0161-5505

Conference paper

Whittington A, Sharp DJ, Gunn RN, 2018, Spatiotemporal distribution of β-amyloid in Alzheimer's disease results from heterogeneous regional carrying capacities, Journal of Nuclear Medicine, Vol: 59, Pages: 822-827, ISSN: 1535-5667

β-amyloid (Aβ) accumulation in the brain is one of two pathological hallmarks of Alzheimer's Disease (AD) and its spatial distribution has been studied extensively ex vivo. We apply mathematical modelling to Aβ in vivo PET imaging data in order to investigate competing theories of Aβ spread in AD. Our results provide evidence that Aβ accumulation starts in all brain regions simultaneously and that its spatiotemporal distribution is a result of heterogeneous regional carrying capacities (regional maximum possible concentration of Aβ) for the aggregated protein rather than longer term spreading from seed regions.

Journal article

Mc Ardle R, Morris R, Hickey A, Del Din S, Koychev I, Gunn RN, Lawson J, Zamboni G, Ridha B, Sahakian BJ, Rowe JB, Thomas A, Zetterberg H, MacKay C, Lovestone S, Rochester Let al., 2018, Gait in Mild Alzheimer's Disease: Feasibility of Multi-Center Measurement in the Clinic and Home with Body-Worn Sensors: A Pilot Study, JOURNAL OF ALZHEIMERS DISEASE, Vol: 63, Pages: 331-341, ISSN: 1387-2877

Journal article

Firouzian A, Whittington A, Searle GE, Koychev I, Zamboni G, Lovestone S, Gunn RNet al., 2018, Imaging A beta and tau in early stage Alzheimer's disease with [F-18]AV45 and [F-18]AV1451, EJNMMI Research, Vol: 8, ISSN: 2191-219X

Background:AD is a progressive neurodegenerative disorder that is associated with the accumulation of two different insoluble protein aggregates, Aβ plaques and hyperphosphorylated tau. This study aimed to investigate the optimal acquisition and quantification of [18F]AV45 and [18F]AV1451 to image Aβ and tau, respectively, in subjects with AD.Fifteen subjects with early stage AD underwent a T1-weighted structural MRI and two dynamic PET scans to image Aβ (60 min, [18F]AV45) and tau (120 min, [18F]AV1451). Both dynamic BPND and static SUVR outcome measures were calculated and compared for 12 out of 15 subjects who completed 60 min of the Aβ PET scan and at least 110 min of the tau PET scan. The SRTM and reference Logan graphical analysis were applied to the dynamic data to estimate regional BPND values and SUVR ratios from the static data. Optimal acquisition windows were explored for both the dynamic and static acquisitions. In addition, the spatial correlation between regional Aβ and tau signals was explored.Results:Both the SRTM and graphical analysis methods showed a good fit to the dynamic data for both Aβ and tau dynamic PET scans. Mean regional BPND estimates became stable 30 min p.i. for [18F]AV45 and 80 min p.i. for [18F]AV1451.Time stability analysis of static SUVR data showed that the outcome measure starts to become stable for scan windows of 30–50 min p.i. for [18F]AV45 and 80–100 min p.i. for [18F]AV1451. The results from these time windows correlated well with the results from the full dynamic analysis for both tracers (R2 = 0.74 for [18F]AV45 and R2 = 0.88 for [18F]AV1451). There was a high correlation between amyloid uptake estimate using both dynamic analysis methods in thalamus and tau uptake in thalamus, hippocampus and amygdala.Conclusions:Short static PET scans at appropriate time windows provided SUVR values which were in reasonable agreement with BPND values calculated from

Journal article

Law J, Morris DE, Izzi-Engbeaya CN, Salem V, Coello C, Robinson L, Jayasinghe M, Scott R, Gunn R, Rabiner E, Tan T, Dhillo WS, Bloom SR, Budge H, Symonds MEet al., 2018, Thermal imaging is a non-invasive alternative to PET-CT for measurement of brown adipose tissue activity in humans, Journal of Nuclear Medicine, Vol: 59, Pages: 516-522, ISSN: 1535-5667

Obesity and its metabolic consequences are a major cause of morbidity and mortality. Brown adipose tissue (BAT) utilizes glucose and free fatty acids to produce heat, thereby increasing energy expenditure. Effective evaluation of human BAT stimulators is constrained by the current standard method of assessing BAT—PET/CT—as it requires exposure to high doses of ionizing radiation. Infrared thermography (IRT) is a potential noninvasive, safe alternative, although direct corroboration with PET/CT has not been established. Methods: IRT and 18F-FDG PET/CT data from 8 healthy men subjected to water-jacket cooling were directly compared. Thermal images were geometrically transformed to overlay PET/CT-derived maximum intensity projection (MIP) images from each subject, and the areas with the most intense temperature and glucose uptake within the supraclavicular regions were compared. Relationships between supraclavicular temperatures (TSCR) from IRT and the metabolic rate of glucose uptake (MR(gluc)) from PET/CT were determined. Results: Glucose uptake on MR(gluc)MIP was found to correlate positively with a change in TSCR relative to a reference region (r2 = 0.721; P = 0.008). Spatial overlap between areas of maximal MR(gluc)MIP and maximal TSCR was 29.5% ± 5.1%. Prolonged cooling, for 60 min, was associated with a further TSCR rise, compared with cooling for 10 min. Conclusion: The supraclavicular hotspot identified on IRT closely corresponded to the area of maximal uptake on PET/CT-derived MR(gluc)MIP images. Greater increases in relative TSCR were associated with raised glucose uptake. IRT should now be considered a suitable method for measuring BAT activation, especially in populations for whom PET/CT is not feasible, practical, or repeatable.

Journal article

Koychev I, Gunn RN, Firouzian A, Lawson J, Zamboni G, Ridha B, Sahakian BJ, Rowe JB, Thomas A, Rochester L, Ffytche D, Howard R, Zetterberg H, MacKay C, Lovestone Set al., 2018, PET Tau and Amyloid-β Burden in Mild Alzheimer's Disease: Divergent Relationship with Age, Cognition, and Cerebrospinal Fluid Biomarkers (vol 60, pg 283, 2017), JOURNAL OF ALZHEIMERS DISEASE, Vol: 63, Pages: 407-407, ISSN: 1387-2877

Journal article

Wadhwa P, Thielemans K, Efthimiou N, Bertolli O, Emond E, Thomas BA, Tohme M, Wangerin KA, Delso G, Hallett W, Gunn RN, Buckley D, Tsoumpas Cet al., 2018, Implementation of Image Reconstruction for GE SIGNA PET/MR PET Data in the STIR Library, IEEE Nuclear Science Symposium and Medical Imaging Conference (NSS/MIC) / 25th International Symposium on Room-Temperature Semiconductor X-Ray and Gamma-Ray Detectors, Publisher: IEEE

Conference paper

Scott GPT, Zetterberg H, Jolly A, Cole JH, De Simoni S, Jenkins PO, Feeney C, Owen DR, Lingford-Hughes A, Howes O, Patel MC, Goldstone AP, Gunn RN, Blennow K, Matthews PM, Sharp DJet al., 2017, Minocycline reduces chronic microglial activation after brain trauma but increases neurodegeneration, Brain, Vol: 141, Pages: 459-471, ISSN: 1460-2156

Survivors of a traumatic brain injury can deteriorate years later, developing brain atrophy and dementia. Traumatic brain injury triggers chronic microglial activation, but it is unclear whether this is harmful or beneficial. A successful chronic-phase treatment for traumatic brain injury might be to target microglia. In experimental models, the antibiotic minocycline inhibits microglial activation. We investigated the effect of minocycline on microglial activation and neurodegeneration using PET, MRI, and measurement of the axonal protein neurofilament light in plasma. Microglial activation was assessed using 11C-PBR28 PET. The relationships of microglial activation to measures of brain injury, and the effects of minocycline on disease progression, were assessed using structural and diffusion MRI, plasma neurofilament light, and cognitive assessment. Fifteen patients at least 6 months after a moderate-to-severe traumatic brain injury received either minocycline 100 mg orally twice daily or no drug, for 12 weeks. At baseline, 11C-PBR28 binding in patients was increased compared to controls in cerebral white matter and thalamus, and plasma neurofilament light levels were elevated. MRI measures of white matter damage were highest in areas of greater 11C-PBR28 binding. Minocycline reduced 11C-PBR28 binding (mean Δwhite matter binding = −23.30%, 95% confidence interval −40.9 to −5.64%, P = 0.018), but increased plasma neurofilament light levels. Faster rates of brain atrophy were found in patients with higher baseline neurofilament light levels. In this experimental medicine study, minocycline after traumatic brain injury reduced chronic microglial activation while increasing a marker of neurodegeneration. These findings suggest that microglial activation has a reparative effect in the chronic phase of traumatic brain injury.

Journal article

Fujita M, Kobayashi M, Ikawa M, Gunn RN, Rabiner EA, Owen DR, Zoghbi SS, Haskali MB, Telu S, Pike VW, Innis RBet al., 2017, Comparison of four (11)C-labeled PET ligands to quantify translocator protein 18 kDa (TSPO) in human brain: (R)-PK11195, PBR28, DPA-713, and ER176-based on recent publications that measured specific-to-non-displaceable ratios., EJNMMI Research, Vol: 7, ISSN: 2191-219X

Translocator protein (TSPO) is a biomarker for detecting neuroinflammation by PET. (11)C-(R)-PK11195 has been used to image TSPO since the 1980s. Here, we compared the utility of four (11)C-labeled ligands-(R)-PK11195, PBR28, DPA-713, and ER176-to quantify TSPO in healthy humans. For all of these ligands, BP ND (specific-to-non-displaceable ratio of distribution volumes) was measured by partially blocking specific binding with XNBD173 administration. In high-affinity binders, DPA-713 showed the highest BP ND of 7.3 followed by ER176 (4.2), PBR28 (1.2), and PK11195 (0.8). Only ER176 allows the inclusion of low-affinity binders because of little influence of radiometabolites and high BP ND. If inclusion of all three genotypes is important for study logistics, ER176 is the best of these four radioligands for studying neuroinflammation.

Journal article

Datta G, Colasanti A, Rabiner EA, Gunn RN, Malik O, Ciccarelli O, Nicholas R, Van Vlierberghe E, Van Hecke W, Searle G, Santos-Ribeiro A, Matthews PMet al., 2017, Neuroinflammation and its relationship to changes in brain volume and white matter lesions in multiple sclerosis, Brain, Vol: 140, Pages: 2927-2938, ISSN: 1460-2156

Brain magnetic resonance imaging is an important tool in the diagnosis and monitoring of multiple sclerosis patients. However, magnetic resonance imaging alone provides limited information for predicting an individual patient’s disability progression. In part, this is because magnetic resonance imaging lacks sensitivity and specificity for detecting chronic diffuse and multi-focal inflammation mediated by activated microglia/macrophages. The aim of this study was to test for an association between 18 kDa translocator protein brain positron emission tomography signal, which arises largely from microglial activation, and measures of subsequent disease progression in multiple sclerosis patients. Twenty-one patients with multiple sclerosis (seven with secondary progressive disease and 14 with a relapsing remitting disease course) underwent T1- and T2-weighted and magnetization transfer magnetic resonance imaging at baseline and after 1 year. Positron emission tomography scanning with the translocator protein radioligand 11C-PBR28 was performed at baseline. Brain tissue and lesion volumes were segmented from the T1- and T2-weighted magnetic resonance imaging and relative 11C-PBR28 uptake in the normal-appearing white matter was estimated as a distribution volume ratio with respect to a caudate pseudo-reference region. Normal-appearing white matter distribution volume ratio at baseline was correlated with enlarging T2-hyperintense lesion volumes over the subsequent year (ρ = 0.59, P = 0.01). A post hoc analysis showed that this association reflected behaviour in the subgroup of relapsing remitting patients (ρ = 0.74, P = 0.008). By contrast, in the subgroup of secondary progressive patients, microglial activation at baseline was correlated with later progression of brain atrophy (ρ = 0.86, P = 0.04). A regression model including the baseline normal-appearing white matter distribution volume ratio, T2 lesion volume and normal-appearing white matter magnet

Journal article

Bowles, Qin C, Guerrero R, Gunn R, Hammers A, Dickie D, Valdes Hernandez M, Wardlaw J, Rueckert Det al., 2017, Brain Lesion Segmentation through Image Synthesis and Outlier Detection, NeuroImage: Clinical, Vol: 16, Pages: 643-658, ISSN: 2213-1582

Cerebral small vessel disease (SVD) can manifest in a number of ways. Many of these result in hyperintense regions visible on T2-weighted magnetic resonance (MR) images. The automatic segmentation of these lesions has been the focus of many studies. However, previous methods tended to be limited to certain types of pathology, as a consequence of either restricting the search to the white matter, or by training on an individual pathology. Here we present an unsupervised abnormality detection method which is able to detect abnormally hyperintense regions on FLAIR regardless of the underlying pathology or location. The method uses a combination of image synthesis, Gaussian mixture models and one class support vector machines, and needs only be trained on healthy tissue. We evaluate our method by comparing segmentation results from 127 subjects with SVD with three established methods and report significantly superior performance across a number of metrics.

Journal article

Datta G, Colasanti A, Kalk N, Owen DR, Scott G, Rabiner EI, Gunn R, Lingford-Hughes A, Malik O, Ciccarelli O, Nicholas R, Nie L, Battaglini M, De Stefano N, Matthews Pet al., 2017, [(11)C]PBR28 or [(18)F]PBR111 detect white matter inflammatory heterogeneity in multiple sclerosis, Journal of Nuclear Medicine, Vol: 58, Pages: 1477-1482, ISSN: 1535-5667

Objective: To assess microglial activation in lesions and in normal appearing white matter of multiple sclerosis (MS) patients using positron emission tomography (PET). Methods: 34 MS patients (7 with secondary progressive MS (SPMS), 27 with relapsing remitting MS (RRMS)) and 30 healthy volunteers, genetically stratified for translocator protein (TSPO), binding status underwent PET scanning with TSPO radioligands ((11)C-PBR28 or (18)F-PBR111). Regional TSPO availability was measured as a distribution volume ratio (DVR) relative to the caudate (a pseudo-reference region). White matter lesions (WML) were classified as "active" (DVR highest in the lesion), "peripherally active" (peri-lesional DVR highest), "inactive" (DVR highest in surrounding normal appearing white matter, NAWM) or "undifferentiated" (similar DVR across lesion, peri-lesional and NAWM volumes). Results: The mean DVR in NAWM of patients was greater than that of the healthy volunteer white matter for both radioligands. Uptake for individual WML in patients was heterogeneous, but the median WML DVR and NAWM DVR for individual patients were strongly correlated (ρ = 0.94, P = 4x10-11). A higher proportion of lesions were inactive in patients with SPMS (35 %) than RRMS (23 %), but active lesions were found in all patients, including those on highly efficacious treatments. Conclusion: TSPO radioligand uptake was increased in brains of MS patients relative to healthy controls with two TSPO radiotracers. WML showed heterogeneous patterns of uptake. Active lesions were found in patients with both RRMS and SPMS. Their independent prognostic significance needs further investigation.

Journal article

Koychev I, Gunn RN, Firouzian A, Lawson J, Zamboni G, Ridha B, Sahakian BJ, Rowe JB, Thomas A, Rochester L, Ffytche D, Howard R, Zetterberg H, MacKay C, Lovestone S, Deep and Frequent Phenotyping study teamet al., 2017, PET Tau and Amyloid-β Burden in Mild Alzheimer's Disease: Divergent Relationship with Age, Cognition, and Cerebrospinal Fluid Biomarkers., JOURNAL OF ALZHEIMERS DISEASE, Vol: 60, Pages: 283-293, ISSN: 1387-2877

BACKGROUND: Combining PET amyloid-β (Aβ) and tau imaging may be critical for tracking disease progression in Alzheimer's disease (AD). OBJECTIVE: We sought to characterize the relationship between Aβ and tau ligands as well as with other measures of pathology. METHODS: We conducted a multi-center observational study in early AD (MMSE >20) participants aged 50 to 85 y. The schedule included cognitive assessments (ADAS-Cog) and CSF measurement of Aβ and tau at baseline and 6 months; PET-CT imaging with Aβ ([18F]AV45) and tau ([18F]AV1451) ligands at baseline. RESULTS: 22 participants took part in the study with 20 completing its 6-month duration and 12 having both tau and amyloid PET. The PET biomarker analysis revealed a strong negative correlation between age and tau in multiple regions. Entorhinal cortex tau and age interacted significantly in terms of cognitive change over 6 months which may have been to older participants deteriorating faster despite lower levels of cortical tau. Cortical Aβ associated with entorhinal cortex tau while CSF tau/Aβ ratio correlated strongly with cortical tau but not Aβ. CONCLUSION: The negative relationship between age and cortical tau whereby younger patients with mild AD had relatively greater tau burden is potentially important. It suggests that younger-age onset AD may be primarily driven by tau pathology while AD developing later may depend on a multitude of pathological mechanisms. These data also suggest that PET-tau performs better than PET-amyloid in predicting the best validated AD diagnostic marker- the CSF total tau/Aβ ratio.

Journal article

Niccolini F, Wilson H, Pagano G, Coello C, Mehta MA, Searle GE, Gunn RN, Rabiner EA, Foltynie T, Politis Met al., 2017, Loss of phosphodiesterase 4 in Parkinson disease Relevance to cognitive deficits, NEUROLOGY, Vol: 89, Pages: 586-593, ISSN: 0028-3878

Journal article

Niccolini F, Mencacci NE, Rabiner E, Salpietro V, Pagano G, Balint B, Houlden H, Gunn R, Wood NW, Bhatia KP, Politis Met al., 2017, Loss of PDE10A expression in patients with PDE10A and ADYC5 mutations, 3rd Congress of the European-Academy-of-Neurology, Publisher: WILEY, Pages: 659-659, ISSN: 1351-5101

Conference paper

Pagano G, Niccolini F, Wilson H, Yousaf T, Khan N, Martino D, Gunn R, Rabiner E, Politis Met al., 2017, Altered PDE10A expression detectable early in untreated Parkinson's disease patients, 3rd Congress of the European-Academy-of-Neurology, Publisher: WILEY, Pages: 45-45, ISSN: 1351-5101

Conference paper

Niccolini F, Wilson H, Hirschbichler S, Pagano G, Erro R, Yousaf T, Whittington A, Holton J, Martino D, Rabiner E, Gunn R, Bhatia KP, Politis Met al., 2017, In-vivo evaluation of tau and amyloid pathology in Corticobasal Syndrome, 3rd Congress of the European-Academy-of-Neurology, Publisher: WILEY, Pages: 565-565, ISSN: 1351-5101

Conference paper

Coello C, Fisk M, Mohan D, Wilson FJ, Brown AP, Polkey MI, Wilkinson I, Tal-Singer R, Murphy PS, Cheriyan J, Gunn RNet al., 2017, Quantitative analysis of dynamic F-18-FDG PET/CT for measurement of lung inflammation, EJNMMI RESEARCH, Vol: 7, ISSN: 2191-219X

Background:An inflammatory reaction in the airways and lung parenchyma, comprised mainly of neutrophils and alveolar macrophages, is present in some patients with chronic obstructive pulmonary disease (COPD). Thoracic fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) has been proposed as a promising imaging biomarker to assess this inflammation. We sought to introduce a fully quantitative analysis method and compare this with previously published studies based on the Patlak approach using a dataset comprising 18F-FDG PET scans from COPD subjects with elevated circulating inflammatory markers (fibrinogen) and matched healthy volunteers (HV). Dynamic 18F-FDG PET scans were obtained for high-fibrinogen (>2.8 g/l) COPD subjects (N = 10) and never smoking HV (N = 10). Lungs were segmented using co-registered computed tomography images and subregions (upper, middle and lower) were semi-automatically defined. A quantitative analysis approach was developed, which corrects for the presence of air and blood in the lung (qABL method), enabling direct estimation of the metabolic rate of FDG in lung tissue. A normalised Patlak analysis approach was also performed to enable comparison with previously published results. Effect sizes (Hedge’s g) were used to compare HV and COPD groups.Results:The qABL method detected no difference (Hedge’s g = 0.15 [−0.76 1.04]) in the tissue metabolic rate of FDG in the whole lung between HV (μ = 6.0 ± 1.9 × 10−3 ml cm−3 min−1) and COPD (μ = 5.7 ± 1.7 × 10−3 ml cm−3 min−1). However, analysis with the normalised Patlak approach detected a significant difference (Hedge’s g = −1.59 [−2.57 −0.48]) in whole lung between HV (μ = 2.9 ± 0.5 ×&

Journal article

Paul S, Liow J-S, Gallagher E, Zoghbi S, Gunn R, Fregonara PZ, Morse C, Pike V, Innis R, Fujita Met al., 2017, Building a database for brain 18kDa translocator protein (TSPO) imaged using [11C]PBR28 in healthy subjects, Annual Meeting of the Society-of-Nuclear-Medicine-and-Molecular-Imaging (SNMMI), Publisher: SOC NUCLEAR MEDICINE INC, ISSN: 0161-5505

Conference paper

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