Quantification Supports Amyloid PET Visual Assessment of Challenging Cases: Results from the AMYPAD Diagnostic and Patient Management Study

作者：Lyduine Eisa Collij, Gérard N. Bischof, Daniele Altomare, Ilse Bader, Mark R Battle, David Vállez García, Isadora Lopes Alves, Robin Wolz, Rossella Gismondi, Andrew Wills Stephens, Zuzana Walker, Philip Scheltens, Agneta K. Nordberg, Juan Domingo Gispert, Alexander E. Drzezga, Andrés Perissinotti, Silvia Daniela Morbelli, Christopher Buckley, Valentina Garibotto, Giovanni Battista Frisoni, Gill Farrar, Frederik Barkhof · 发表于：Journal of Nuclear Medicine · 年份：2024 · DOI：10.2967/jnumed.124.268119 · 被引用次数：42 · 研究领域：Medical Imaging Techniques and Applications、Advanced MRI Techniques and Applications、Radiomics and Machine Learning in Medical Imaging

Several studies have demonstrated strong agreement between routine clinical visual assessment and quantification, suggesting that quantification approaches could support assessment by less experienced readers or in challenging cases. However, all studies to date have implemented a retrospective case collection, and challenging cases were generally underrepresented. Methods: We included all participants (n = 741) from the AMYPAD diagnostic and patient management study with available baseline amyloid PET quantification. Quantification was done with the PET-only AmyPype pipeline, providing global Centiloid and regional z scores. Visual assessment was performed by local readers for the entire cohort. From the total cohort, we selected a subsample of 85 cases for which the amyloid status based on the local reader’s visual assessment and the Centiloid classification (cutoff = 21) was discordant or that were assessed with low confidence (i.e., ≤3 on a 5-point scale) by the local reader. In addition, concordant negative (n = 8) and positive (n = 8) scans across tracers were selected. In this sample (n = 101 cases; [18F]flutemetamol, n = 48; [18F]florbetaben, n = 53), the visual assessments and corresponding confidence by 5 certified independent central readers were captured before and after disclosure of the quantification results. Results: For the whole AMYPAD diagnostic and patient management study cohort, overall assessment by local readers highly agreed with Centiloid status (κ =...