Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26262
Title: A multisite analysis of the concordance between visual image interpretation and quantitative analysis of [18F]flutemetamol amyloid PET images.
Austin Authors: Bucci, Marco;Savitcheva, Irina;Farrar, Gill;Salvadó, Gemma;Collij, Lyduine;Doré, Vincent ;Gispert, Juan Domingo;Gunn, Roger;Hanseeuw, Bernard;Hansson, Oskar;Shekari, Mahnaz;Lhommel, Renaud;Molinuevo, José Luis;Rowe, Christopher C ;Sur, Cyrille;Whittington, Alex;Buckley, Christopher;Nordberg, Agneta
Affiliation: Department of Aging, Karolinska University Hospital, Stockholm, Sweden
Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
Pharmaceutical Diagnostics, GE Healthcare, Amersham, UK
Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
University of Melbourne, Melbourne, Australia
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Invicro, London, UK
Neurology and Nuclear Medicine Departments, Saint-Luc University Hospital, Av. Hippocrate, 10, 1200, Brussels, Belgium
Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Universitat Pompeu Fabra, Barcelona, Spain
Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
Universitat Pompeu Fabra, Barcelona, Spain
Invicro, London, UK
Centro de Investigación Biomédica en Red Bioingenieriá, Biomateriales y Nanomedicina, (CIBER-BBN), Barcelona, Spain
Medical Radiation Physics and Nuclear Medicine, Section for Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
Department of Medicine, The University of Melbourne, Melbourne, Australia
Health and Biosecurity, CSIRO, Parkville, Australia
Merck & Co., Inc., Kenilworth, NJ, USA
Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
Clinical Memory Research Unit, Department of Clinical Sciences Malmo, Lund University, Lund, Sweden
Neurology and Nuclear Medicine Departments, Saint-Luc University Hospital, Av. Hippocrate, 10, 1200, Brussels, Belgium
Molecular Imaging and Therapy
Issue Date: Jul-2021
metadata.dc.date: 2021-04-12
Publication information: European Journal of Nuclear Medicine and Molecular Imaging 2021; 48(7): 2183-2199
Abstract: [18F]flutemetamol PET scanning provides information on brain amyloid load and has been approved for routine clinical use based upon visual interpretation as either negative (equating to none or sparse amyloid plaques) or amyloid positive (equating to moderate or frequent plaques). Quantitation is however fundamental to the practice of nuclear medicine and hence can be used to supplement amyloid reading methodology especially in unclear cases. A total of 2770 [18F]flutemetamol images were collected from 3 clinical studies and 6 research cohorts with available visual reading of [18F]flutemetamol and quantitative analysis of images. These were assessed further to examine both the discordance and concordance between visual and quantitative imaging primarily using thresholds robustly established using pathology as the standard of truth. Scans covered a wide range of cases (i.e. from cognitively unimpaired subjects to patients attending the memory clinics). Methods of quantifying amyloid ranged from using CE/510K cleared marked software (e.g. CortexID, Brass), to other research-based methods (e.g. PMOD, CapAIBL). Additionally, the clinical follow-up of two types of discordance between visual and quantitation (V+Q- and V-Q+) was examined with competing risk regression analysis to assess possible differences in prediction for progression to Alzheimer's disease (AD) and other diagnoses (OD). Weighted mean concordance between visual and quantitation using the autopsy-derived threshold was 94% using pons as the reference region. Concordance from a sensitivity analysis which assessed the maximum agreement for each cohort using a range of cut-off values was also estimated at approximately 96% (weighted mean). Agreement was generally higher in clinical cases compared to research cases. V-Q+ discordant cases were 11% more likely to progress to AD than V+Q- for the SUVr with pons as reference region. Quantitation of amyloid PET shows a high agreement vs binary visual reading and also allows for a continuous measure that, in conjunction with possible discordant analysis, could be used in the future to identify possible earlier pathological deposition as well as monitor disease progression and treatment effectiveness.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26262
DOI: 10.1007/s00259-021-05311-5
ORCID: 0000-0001-7345-5151
PubMed URL: 33844055
Type: Journal Article
Subjects: Alzheimer’s disease
Amyloid PET
Image interpretation
Quantification
Visual inspection
[18F]flutemetamol
Appears in Collections:Journal articles

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