A multisite analysis of the concordance between visual image interpretation and quantitative analysis of [18F]flutemetamol amyloid PET images

被引:27
作者
Bucci, Marco [1 ]
Savitcheva, Irina [2 ]
Farrar, Gill [3 ]
Salvado, Gemma [4 ,5 ]
Collij, Lyduine [6 ]
Dore, Vincent [7 ,8 ]
Gispert, Juan Domingo [4 ,5 ,9 ,10 ]
Gunn, Roger [11 ,12 ]
Hanseeuw, Bernard [13 ,14 ,15 ]
Hansson, Oskar [16 ]
Shekari, Mahnaz [4 ,5 ,9 ]
Lhommel, Renaud [13 ,14 ]
Molinuevo, Jose Luis [4 ,5 ,9 ,17 ]
Rowe, Christopher [7 ,18 ]
Sur, Cyrille [19 ]
Whittington, Alex [11 ]
Buckley, Christopher [3 ]
Nordberg, Agneta [1 ,20 ]
机构
[1] Karolinska Inst, Div Clin Genet, Dept Neurobiol, Ctr Alzheimer Res,Care Sci & Soc, Stockholm, Sweden
[2] Karolinska Univ Hosp, Sect Nucl Med, Med Radiat Phys & Nucl Med, Stockholm, Sweden
[3] GE Healthcare, Pharmaceut Diagnost, Chicago, IL USA
[4] Pasqual Maragall Fdn, Barcelonasseta Brain Res Ctr BBRC, Barcelona, Spain
[5] Hosp del Mar, IMIM, Med Res Inst, Barcelona, Spain
[6] Vrije Univ Amsterdam, Dept Radiol & Nucl Med, Amsterdam UMC, NL-1117 Amsterdam, Netherlands
[7] Univ Melbourne, Austin Hlth, Melbourne, Vic, Australia
[8] CSIRO, Hlth & Biosecur, Parkville, Vic, Australia
[9] Univ Pompeu Fabra, Barcelona, Spain
[10] Ctr Invest Biomed Red Bioingn Biomat & Nanomed CI, Barcelona, Spain
[11] Invicro, London, England
[12] Imperial Coll, Div Brain Sci, Dept Med, London, England
[13] St Luc Univ Hosp, Neurol Dept, Av Hippocrate 10, B-1200 Brussels, Belgium
[14] St Luc Univ Hosp, Nucl Med Dept, Av Hippocrate 10, B-1200 Brussels, Belgium
[15] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiol, Gordon Ctr Med Imaging, Boston, MA USA
[16] Lund Univ, Dept Clin Sci, Clin Memory Res Unit, Lund, Sweden
[17] Ctr Invest Biomed Red Fragilidad Envejecimiento S, Madrid, Spain
[18] Univ Melbourne, Dept Med, Melbourne, Vic, Australia
[19] Merck & Co Inc, Kenilworth, NJ USA
[20] Karolinska Univ Hosp, Dept Aging, Stockholm, Sweden
关键词
Amyloid PET; F-18]flutemetamol; Image interpretation; Visual inspection; Quantification; Alzheimer’ s disease; QUANTIFICATION; DISEASE; INDIVIDUALS; VALIDATION; IMPACT;
D O I
10.1007/s00259-021-05311-5
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Background [F-18]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. Methods A total of 2770 [F-18]flutemetamol images were collected from 3 clinical studies and 6 research cohorts with available visual reading of [F-18]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). Results 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. Conclusions 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.
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页码:2183 / 2199
页数:17
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