Please use this identifier to cite or link to this item: https://hdl.handle.net/10316/107194
Title: Semi-quantification and grading of amyloid PET: A project of the European Alzheimer's Disease Consortium (EADC)
Authors: Chincarini, A.
Peira, E.
Morbelli, S.
Pardini, M.
Bauckneht, M.
Arbizu, J.
Castelo-Branco, Miguel 
Büsing, K. A.
de Mendonça, A.
Didic, M.
Dottorini, M.
Engelborghs, S.
Ferrarese, C.
Frisoni, G. B.
Garibotto, V.
Guedj, E.
Hausner, L.
Hugon, J.
Verhaeghe, J.
Mecocci, P.
Musarra, M.
Queneau, M.
Riverol, M.
Santana, Isabel 
Guerra, U. P.
Nobili, F.
Keywords: Amyloid PET; Visual assessment; Semi-quantification
Issue Date: 2019
Publisher: Elsevier
Project: Novartis 
Serial title, monograph or event: NeuroImage: Clinical
Volume: 23
Abstract: Background: amyloid-PET reading has been classically implemented as a binary assessment, although the clinical experience has shown that the number of borderline cases is non negligible not only in epidemiological studies of asymptomatic subjects but also in naturalistic groups of symptomatic patients attending memory clinics. In this work we develop a model to compare and integrate visual reading with two independent semi-quantification methods in order to obtain a tracer-independent multi-parametric evaluation. Methods: We retrospectively enrolled three cohorts of cognitively impaired patients submitted to 18F-florbetaben (53 subjects), 18F-flutemetamol (62 subjects), 18F-florbetapir (60 subjects) PET/CT respectively, in 6 European centres belonging to the EADC. The 175 scans were visually classified as positive/negative following approved criteria and further classified with a 5-step grading as negative, mild negative, borderline, mild positive, positive by 5 independent readers, blind to clinical data. Scan quality was also visually assessed and recorded. Semiquantification was based on two quantifiers: the standardized uptake value (SUVr) and the ELBA method. We used a sigmoid model to relate the grading with the quantifiers. We measured the readers accord and inconsistencies in the visual assessment as well as the relationship between discrepancies on the grading and semi-quantifications. Conclusion: It is possible to construct a map between different tracers and different quantification methods without resorting to ad-hoc acquired cases. We used a 5-level visual scale which, together with a mathematical model, delivered cut-offs and transition regions on tracers that are (largely) independent from the population. All fluorinated tracers appeared to have the same contrast and discrimination ability with respect to the negative- to-positive grading. We validated the integration of both visual reading and different quantifiers in a more robust framework thus bridging the gap between a binary and a user-independent continuous scale.
URI: https://hdl.handle.net/10316/107194
ISSN: 22131582
DOI: 10.1016/j.nicl.2019.101846
Rights: openAccess
Appears in Collections:I&D ICNAS - Artigos em Revistas Internacionais
I&D CIBIT - Artigos em Revistas Internacionais
I&D CIBIT - Artigos em Revistas Internacionais
FMUC Medicina - Artigos em Revistas Internacionais

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