Quantitative Evaluation of 18F-Flutemetamol PET in Patients With Cognitive Impairment and Suspected Alzheimer's Disease: A Multicenter Study

Ito, Kengo; Ishii, Kazunari; Shimosegawa, Eku; Okazawa, Hidehiko; Mishina, Masayoshi; Mizumura, Sunao; Okita, Kyoji; Shigemoto, Yoko; Kato, Takashi; Takenaka, Akinori; Kaida, Hayato; Hanaoka, Kohei; Matsunaga, Keiko; Hatazawa, Jun; Ikawa, Masamichi; Tsujikawa, Tetsuya; Morooka, Miyako; Ishibashi, Kenji; Kameyama, Masashi; Yamao, Tensho; Miwa, Koichi; Ogawa, Masayo; Sato, Noriko

doi:10.3389/fneur.2020.578753

Cited by 26 publications

(27 citation statements)

References 24 publications

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“…Equivocal ndings are thus inevitable and lead to interrater variability in visual interpretation [1] because raters have their own experience and potential internal criteria. In addition, in our previous multicenter study using 18 F-utemetamol [2], disagreement between two raters was observed in 9% of cases. Equivocal ndings should be avoided when determining the indication for the disease-modifying drugs currently in development.…”

Section: Introductionmentioning

confidence: 80%

“…The study participants comprised 24 patients (15 men and 9 women; age range, 48-90 years) enrolled in a previous multicenter study [2]. They were recruited from an outpatient memory clinic of the National Center of Neurology and Psychiatry, Japan.…”

Section: Participantsmentioning

confidence: 99%

“…Figure 1 shows the processing pipeline applied to quantitative analysis using the SUVR and the 100-point CL scale [4]. This MRI-based pipeline has already been validated [2] using a GAAIN dataset of 11 C-PiB PET images for 34 young control individuals and 45 typical AD patients downloaded from the GAAIN website. In the present study, low-dose CT instead of MRI was also used for anatomic standardization.…”

Section: Quantitative Analysismentioning

confidence: 99%

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Amyloid PET Quantification Using Low-dose CT-guided Anatomic Standardization

Yamao¹,

Shakado²,

Shigemoto³

et al. 2021

Preprint

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BackgroundCentiloid (CL) scaling has become a standardized quantitative measure in amyloid PET because it facilitates the direct comparison of results across institutions, even when different analytical methods or tracers are used. Standard volumes of interest must be used to calculate the CL scale after the anatomic standardization of amyloid PET images using coregistered MRI; if the MRI is unavailable, the CL scale cannot be accurately calculated. This study sought to determine the substitutability of low-dose CT, which is used to correct PET attenuation in PET/CT equipment, by evaluating the measurement accuracy when low-dose CT is used as an alternative to MRI in the calculation of the CL scale. Amyloid PET images obtained using 18F-flutemetamol from 24 patients with possible or probable Alzheimer’s disease were processed to calculate the CL scale using 3D T1-weighted MRI and low-dose CT of PET/CT. CLMRI and CLCT were respectively defined as the use of MRI and CT for anatomic standardization and compared. Trial registration: Japan Registry of Clinical Trials, jRCTs031180321. Registered 18 March 2019, https://jrct.niph.go.jp/latest-detail/jRCTs031180321.ResultsA Bland–Altman plot showed that CLCT was slightly but significantly underestimated (mean ± standard deviation, −1.7 ± 2.4; p < 0.002) compared with CLMRI. The 95% limits of agreement ranged from −2.8 to −0.7. Pearson correlation analysis showed a highly significant correlation of r = 0.998 between CLCT and CLMRI (p < 0.001). The linear regression equation was CLMRI = 1.027 × CLCT + 0.762. In a Bland-Altman plot, Spearman correlation analysis did not identify a significant association between the CLMRI versus CLCT difference and the CL load (ρ = −0.389, p = 0.060). This slight underestimation of CLCT may derive from slightly higher uptake when the cerebellum is used as a reference area in CT-based anatomically standardized PET images versus MRI-based images.ConclusionsLow-dose CT of PET/CT can substitute for MRI in the anatomic standardization used to calculate the CL scale from amyloid PET, although a slight underestimation occurs.

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Section: Introductionmentioning

confidence: 80%

Section: Participantsmentioning

confidence: 99%

Section: Quantitative Analysismentioning

confidence: 99%

See 1 more Smart Citation

Amyloid PET Quantification Using Low-dose CT-guided Anatomic Standardization

Yamao¹,

Shakado²,

Shigemoto³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Equivocal findings are thus inevitable and lead to interrater variability in visual interpretation [ 2 ] because raters have their own experience and potential internal criteria. In addition, in our previous multicenter study using 18 F-flutemetamol [ 3 ], disagreement between two raters was observed in 9% of cases. Equivocal findings should be avoided when determining the indication for the disease-modifying drugs currently in development.…”

Section: Introductionmentioning

confidence: 95%

Amyloid PET quantification using low-dose CT-guided anatomic standardization

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Centiloid (CL) scaling has become a standardized quantitative measure in amyloid PET because it facilitates the direct comparison of results across institutions, even when different analytical methods or tracers are used. Standard volumes of interest must be used to calculate the CL scale after the anatomic standardization of amyloid PET images using coregistered MRI; if the MRI is unavailable, the CL scale cannot be accurately calculated. This study sought to determine the substitutability of low-dose CT, which is used to correct PET attenuation in PET/CT equipment, by evaluating the measurement accuracy when low-dose CT is used as an alternative to MRI in the calculation of the CL scale. Amyloid PET images obtained using 18F-flutemetamol from 24 patients with possible or probable Alzheimer’s disease were processed to calculate the CL scale using 3D T1-weighted MRI and low-dose CT of PET/CT. CLMRI and CLCT were, respectively, defined as the use of MRI and CT for anatomic standardization and compared. Regional differences in the CT-based and MRI-based standardized anatomic images were also investigated. Trial registration: Japan Registry of Clinical Trials, jRCTs031180321 (registered 18 March 2019, https://jrct.niph.go.jp/latest-detail/jRCTs031180321). Results A Bland–Altman plot showed that CLCT was slightly but significantly underestimated (mean ± standard deviation, − 1.7 ± 2.4; p < 0.002) compared with CLMRI. The 95% limits of agreement ranged from − 2.8 to − 0.7. Pearson correlation analysis showed a highly significant correlation of r = 0.998 between CLCT and CLMRI (p < 0.001). The linear regression equation was CLMRI = 1.027 × CLCT + 0.762. In a Bland–Altman plot, Spearman correlation analysis did not identify a significant association between the difference in CLMRI versus CLCT and CL load (ρ = − 0.389, p = 0.060). This slight underestimation of CLCT may derive from slightly higher uptake when the cerebellum is used as a reference area in CT-based anatomically standardized PET images versus MRI-based images. Conclusions Low-dose CT of PET/CT can substitute for MRI in the anatomic standardization used to calculate the CL scale from amyloid PET, although a slight underestimation occurs.

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“… Florbetapir (FDA approved in 2012) Flutemetamol (can objectively evaluate amyloid positivity. [ 30 ] …”

Section: Amyloid Molecular Imaging (Positron-emission Tomography)mentioning

confidence: 99%

Alzheimer's disease

Dangi

Chatterjee

Banwa

et al. 2021

Industrial Psychiatry Journal

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Fifty million people are affected with dementia worldwide with Alzheimer's disease (AD) accounting for 70%–80% of these cases. In India alone, 4.1 million people suffered from dementia in 2015. To date, there are no definitive treatment options for AD and the overall treatment gap in India stands at 90%. Attempts have been made to define AD biologically. This has been made possible due to advances in the identification of biomarkers that indicate the neuropathological changes responsible for AD. Identification of these biomarkers has implications for disease staging, prognostication, and identifying drug targets. Here, we summarize the advances in the field of biomarkers in AD.

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Quantitative Evaluation of 18F-Flutemetamol PET in Patients With Cognitive Impairment and Suspected Alzheimer's Disease: A Multicenter Study

Cited by 26 publications

References 24 publications

Amyloid PET Quantification Using Low-dose CT-guided Anatomic Standardization

Amyloid PET Quantification Using Low-dose CT-guided Anatomic Standardization

Amyloid PET quantification using low-dose CT-guided anatomic standardization

Alzheimer's disease

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