Detecting Early Alzheimer’s using MR (DREAMER)
Research type
Research Study
Full title
Early Detection Of Alzheimer’s Disease With GlucoCEST MRI: A Feasibility Study.
IRAS ID
308185
Contact name
Gordon Waiter
Contact email
Sponsor organisation
University of Aberdeen and NHS Grampian
Duration of Study in the UK
2 years, 6 months, 31 days
Research summary
Alzheimer’s disease (AD) is the most common cause of dementia, affecting approximately 10% of individuals aged ≥65. Most available treatments aim at controlling symptoms at an early stage rather than providing a cure. Therefore, an accurate and early diagnosis of AD with appropriate management will slow the progression of the condition. Reduced cerebral glucose levels have been observed in patients with early AD. Glucose hypometabolism can be assessed by administering a radioactive glucose analogue, 2-deoxy-2-(18F) fluoro-D-glucose (18FDG), and imaging with PET [8-11]. The high cost and limited availability of PET-CT (computed tomography) still hamper its general clinical application. Moreover, the use of radioactive tracers in combination with the additional ionizing radiation of CT is not suitable for repeated measurements. Therefore, currently, the provisional diagnosis of AD is still based on the combination of clinical history, neurological examination, cognitive testing over a period of time, and structural neuroimaging. This has major time and resource implications.
A radically different and highly innovative means for imaging glucose with MRI has now been established, exploiting the interaction between hydroxyl protons in glucose and the protons in water; the method is termed glucose Chemical Exchange Saturation Transfer (glucoCEST). GlucoCEST MRI is a method that has no reliance on radiolabelled glucose analogues and could become widely implemented in clinic practice. We therefore aim to investigate the potential of glucoCEST MRI in Alzheimer's disease.
Lay summary of study results: Aims: The aim of this study was to investigate whether abnormal brain glucose metabolism in patients with Alzheimer’s disease can be identified using an MRI-based technique called glucoCEST at 3T. We aimed to compare this method to the standard clinical technique, FDG-PET, to see how closely the two approaches agree when estimating glucose metabolism. Finally, we compared glucose uptake in people with Alzheimer’s disease to that of healthy individuals matched for age and sex.
Key findings:
1) Recruitment of participants, including those with Alzheimer’s disease, into the study was achievable enabling successful data collection and all participants tolerated the oral glucose drink without adverse effects.
2) PET imaging with [¹⁸F]FDG in AD patients showed the expected reduction in glucose metabolism in the parietal and temporal lobes, which was associated with memory decline.
3) GlucoCEST MRI showed relatively uniform signal across the brain and did not replicate the typical areas of reduced glucose seen on PET.
4) We did not observe differences in glucoCEST images between patients with Alzheimer’s disease and healthy individuals.REC name
London - South East Research Ethics Committee
REC reference
22/LO/0347
Date of REC Opinion
20 Jun 2022
REC opinion
Further Information Favourable Opinion