In vitro characterization of [ ¹⁸F]-florbetaben, an Aβ imaging radiotracer

Purpose: Amyloid-β (Aβ) plaques are a major pathological hallmark of Alzheimer's disease (AD). The noninvasive detection of Aβ plaques may increase the accuracy of clinical diagnosis as well as monitor therapeutic interventions. While [ ¹¹C]-PiB is the most widely used Aβ positron emission tomography (PET) radiotracer, due to the short half-life of ¹¹C (20min), its application is limited to centers with an on-site cyclotron and ¹¹C radiochemistry expertise. Therefore, novel [ ¹⁸F] (half-life 110min)-labeled Aβ PET tracers have been developed. We have demonstrated that [ ¹⁸F]-florbetaben-PET can differentiate individuals diagnosed with AD from healthy elderly, Parkinson's disease and frontotemporal lobe dementia (FTLD-tau) patients. While [ ¹⁸F]-florbetaben-PET retention matched the reported postmortem distribution of Aβ plaques, the nature of [ ¹⁸F]-florbetaben binding to other pathological lesions comprising misfolded proteins needs further assessment. The objective of this study was to determine whether Florbetaben selectively binds to Aβ plaques in postmortem tissue specimens containing mixed pathological hallmarks (i.e., tau and α-synuclein aggregates). Method: Human AD, FTLD-tau and dementia with Lewy bodies (DLB) brain sections were analyzed by [ ¹⁸F]-florbetaben autoradiography and [ ³H]-florbetaben high-resolution emulsion autoradiography and [ ¹⁹F]-florbetaben fluorescence microscopy. Results: Both autoradiographical analyses demonstrated that Florbetaben exclusively bound Aβ plaques in AD brain sections at low nanomolar concentrations. Furthermore, at concentrations thousand-folds higher than those during a PET scan, [ ¹⁹F]-florbetaben did not bind to α-synuclein or tau aggregates in DLB and FTLD-tau brain sections, respectively. Detection of [ ¹⁹F]-florbetaben staining by fluorescence microscopy in several AD brain regions demonstrated that Florbetaben identified Aβ plaques in all brain regions examined. Conclusion: This study provides further evidence that [ ¹⁸F]-florbetaben-PET is a highly selective radiotracer to assess Aβ plaque deposition in the brain.