Procedural pitfalls and artifacts utilizing Florbetapir F18, a novel PET brain radiotracer used for imaging beta-amyloid plaques, the hallmark pathology associated with Alzheimer's disease

2312 Objectives Tailor and improve the efficiency of a Florbetapir F18 scan, an imaging agent that targets β-amyloid plaque depositions in the brain. Novel PET brain radiotracers, such as Florbetapir F18 have the potential to aid in the diagnosis and management of patients with suspected or known Alzheimer’s disease. However, PET imaging of patients with mild cognitive impairment or dementia can become a challenging endeavor. The acquisition and processing protocols for these studies are subject to pitfalls and artifacts related to both patient and technical characteristics, which could limit the clinical utility of the scan. Methods Over 1000 subjects, located at more than 100 centers with dedicated PET and PET/CT systems from all major manufacturers have undergone PET brain imaging utilizing Florbetapir F18. Images have undergone rigorous quality control measures and results summarized. Results Factors that could impact the quality and integrity of a scan include patient motion, poor patient positioning, improper imaging techniques and inherent scanner equipment problems. In addition, amyloid imaging tracers have minimum recommended uptake and washout times to achieve appropriate image contrast. The recommended routine Florbetapir F18 PET imaging protocols will be presented, as well as specific examples of imaging artifacts; procedural challenges and interesting scan findings. Conclusions Advancements in β-amyloid imaging agents, such as Florbetapir F18, has sparked optimism for a resurgence in molecular imaging within the nuclear medicine community. However, given the limited number of sites with β-amyloid PET brain imaging experience, it is essential that PET technologists become more familiar with the relevant issues and be able to successfully identify and solve problems as they arise. Research Support Avid Radiopharmaceuticals, Inc