Quantitative evaluation of beta-amyloid brain PET imaging in dementia: a comparison between two commercial software packages and the clinical report

Curry, Sorcha; Patel, Neva; Fakhry-Darian, Daniel; Khan, Saba; Perry, Richard; Malhotra, Paresh; Nijran, K. S.; Win, Zarni

doi:10.1259/bjr.20181025

Cited by 8 publications

(3 citation statements)

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“…Although syngo.MI Neurology is provided by PET/CT vendors, several studies have shown that there is no significant difference in results when using the program compared with other analysis programs. Since the measured values using syngo.MI Neurology in various studies have been reported as research results, the same method was applied in our study [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Quantitative comparative analysis of amyloid PET images using three radiopharmaceuticals

et al. 2023

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Objective Amyloid positron emission tomography (PET) with F-18 florbetaben (FBB), F-18 flutemetamol (FMM), and F-18 florapronol (FPN) is being used clinically for the evaluation of dementia. These radiopharmaceuticals are commonly used to evaluate the accumulation of beta-amyloid plaques in the brain, but there are structural differences between them. We investigated whether there are any differences in the imaging characteristics. Methods A total of 605 subjects were enrolled retrospectively in this study, including healthy subjects (HS) and patients with mild cognitive impairment or Alzheimer’s disease. Participants underwent amyloid PET imaging using one of the three radiopharmaceuticals. The PET images were analyzed visually and semi-quantitatively using a standardized uptake value ratio (SUVR). In addition, we calculated and compared the cut-off SUVR of the representative regions for each radiopharmaceutical that can distinguish between positive and negative scans. Results In the negative images of the HS group, the contrast between the white matter and the gray matter was high in the FMM PET images, while striatal uptake was relatively higher in the FPN PET images. The SUVR showed significant differences across the radiopharmaceuticals in all areas except the temporal lobe, but the range of differences was relatively small. Accuracy levels for the global cut-off SUVR to discriminate between positive and negative images were highest in FMM PET, with a value of 0.989. FBB PET also showed a high value of 0.978, while FPN PET showed a relatively low value of 0.901. Conclusions Negative amyloid PET images using the three radiopharmaceuticals showed visually and quantitatively similar imaging characteristics except in the striatum. Binary classification using the cut-off of the global cortex showed high accuracy overall, although there were some differences between the three PET images.

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Section: Discussionmentioning

confidence: 99%

Quantitative comparative analysis of amyloid PET images using three radiopharmaceuticals

et al. 2023

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“…The ligand changed from 18F‐florbetapir (Amyvid) to 18F‐florbetaben (Neuraceq) in December 2017, following the cessation of 18F‐florbetapir manufacture in the UK. Amyloid PET acquisition for this cohort was as previously described 30 …”

Section: Methodsmentioning

confidence: 99%

Alzheimer's disease heterogeneity revealed by neuroanatomical normative modeling

Loreto,

Verdi,

Kia

et al. 2024

Alz & Dem Diag Ass & Dis Mo

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INTRODUCTIONOverlooking the heterogeneity in Alzheimer's disease (AD) may lead to diagnostic delays and failures. Neuroanatomical normative modeling captures individual brain variation and may inform our understanding of individual differences in AD‐related atrophy.METHODSWe applied neuroanatomical normative modeling to magnetic resonance imaging from a real‐world clinical cohort with confirmed AD (n = 86). Regional cortical thickness was compared to a healthy reference cohort (n = 33,072) and the number of outlying regions was summed (total outlier count) and mapped at individual‐ and group‐levels.RESULTSThe superior temporal sulcus contained the highest proportion of outliers (60%). Elsewhere, overlap between patient atrophy patterns was low. Mean total outlier count was higher in patients who were non‐amnestic, at more advanced disease stages, and without depressive symptoms. Amyloid burden was negatively associated with outlier count.DISCUSSIONBrain atrophy in AD is highly heterogeneous and neuroanatomical normative modeling can be used to explore anatomo‐clinical correlations in individual patients.

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“…For 18F-Florbetapir, a 20-min acquisition of the brain was obtained following a 40-min interval post-injection of an intravenous bolus of 370 MBq (minimum 333MBq); for 18F-Florbetaben, a 30-min brain acquisition was obtained following a 90-min interval post-injection of an intravenous bolus of 360 MBq (minimum 240MBq). A low dose CT image was also acquired and used for attenuation correction and anatomical localization of the PET images 47 . Both the Amyvid and Neuraceq images were reconstructed using OSEM 3D, 4 iterations, 14 subsets, 168 matrix size, zoom 2, Gaussian 3mm FWHM.…”

Section: Methodsmentioning

confidence: 99%

Examining real-world Alzheimer’s disease heterogeneity using neuroanatomical normative modelling

Loreto

Verdi

Kia

et al. 2022

Preprint

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Alzheimer′s disease (AD) has been traditionally associated with episodic memory impairment and medial temporal lobe atrophy. However, recent literature has highlighted the existence of atypical forms of AD, presenting with different cognitive and radiological profiles. Failure to appreciate the heterogeneity of AD in the past has led to misdiagnoses, diagnostic delays, clinical trial failures and risks limiting our understanding of the disease. AD research requires the incorporation of new analytic methods that are as free as possible from the intragroup homogeneity assumption underlying case-control approaches according to which patients belonging to the same group are comparable to each other. Neuroanatomical normative modelling is a promising technique allowing for modelling the variation in neuroimaging profiles and then assessing individual deviations from the respective distribution. Here, neuroanatomical normative modelling was applied for the first time to a real-worldclinical cohortof Alzheimer′s disease patients (n=86) who had a positive amyloid PET scan and a T1-weighted MR performed as part of their diagnostic workup. The model indexed normal cortical thickness distributions using a separate healthy reference dataset (n= 33,072), employing hierarchical Bayesian regression to predict cortical thickness per region using age and sex. Transfer learning was used to recalibrate the normative model on avalidation cohort(n=20) of scanner-matched cognitively normal individuals. Brain heterogeneity was quantified as z-scores at each of the 148 ROIs generated within each AD patient. Z-scores < -1.96 defined as outliers. Clinical features including disease severity, presenting phenotypes and comorbidities were collected from health records to explore their association with outlier profiles. Amyloid quantification was performed using an automated PET-only driven method to examine the association between amyloid burden and outliers. The total number of individual outliers (total outlier count) in biomarker-confirmed AD clinical patients ranged between 1 and 120 out of 148 (median 21.5). The superior temporal sulcus was the region with the highest count of outliers (60%) in AD patients. The mean proportion of outliers was higher in the temporal (31.5%) than in the extratemporal (19.1%) regions and up to 20% of patients had no temporal outliers. We found higher mean outlier count in patients with non-amnestic phenotypes, at more advanced disease stages and without depressive symptoms. Amyloid burden was negatively associated with outlier count. This study corroborates the heterogeneity of brain atrophy in AD and provides evidence that this approach can be used to explore anatomo-clinical correlations at an individual level.

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Quantitative evaluation of beta-amyloid brain PET imaging in dementia: a comparison between two commercial software packages and the clinical report

Cited by 8 publications

References 8 publications

Quantitative comparative analysis of amyloid PET images using three radiopharmaceuticals

Quantitative comparative analysis of amyloid PET images using three radiopharmaceuticals

Alzheimer's disease heterogeneity revealed by neuroanatomical normative modeling

Examining real-world Alzheimer’s disease heterogeneity using neuroanatomical normative modelling

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