The Early Perfusion Image Is Useful to Support the Visual Interpretation of Brain Amyloid-PET With 18F-Flutemetamol in Borderline Cases
(2024) In Clinical Nuclear Medicine 49(9). p.838-846- Abstract
Purpose Visual interpretation of brain amyloid-β (Aβ) PET can be difficult in individuals with borderline Aβ burden. Coregistration with individual MRI is recommended in these cases, which, however, is not always available. This study evaluated coregistration with the early perfusion frames acquired immediately after tracer injection to support the visual interpretation of the late Aβ-frames in PET with 18F-flutemetamol (FMM). Patients and Methods Fifty dual-time-window FMM-PET scans of cognitively normal subjects with 0 to 60 Centiloids were included retrospectively (70.1 ± 6.9 years, 56% female, MMSE score 28.9 ± 1.3, 42% APOE ϵ4 carrier). Regional Aβ load was scored with respect to a 6-point Likert scale by 3 independent... (More)
Purpose Visual interpretation of brain amyloid-β (Aβ) PET can be difficult in individuals with borderline Aβ burden. Coregistration with individual MRI is recommended in these cases, which, however, is not always available. This study evaluated coregistration with the early perfusion frames acquired immediately after tracer injection to support the visual interpretation of the late Aβ-frames in PET with 18F-flutemetamol (FMM). Patients and Methods Fifty dual-time-window FMM-PET scans of cognitively normal subjects with 0 to 60 Centiloids were included retrospectively (70.1 ± 6.9 years, 56% female, MMSE score 28.9 ± 1.3, 42% APOE ϵ4 carrier). Regional Aβ load was scored with respect to a 6-point Likert scale by 3 independent raters in the 10 regions of interest recommended for FMM reading using 3 different settings: Aβ image only, Aβ image coregistered with MRI, and Aβ image coregistered with the perfusion image. The impact of setting, within- and between-readers variability, region of interest, and Aβ-status was tested by repeated-measure analysis of variance of the Likert score. Results The Centiloid scale ranged between 2 and 52 (interquartile range, 7-19). Support of visual scoring by the perfusion image resulted in the best discrimination between Aβ-positive and Aβ-negative cases, mainly by improved certainty of excluding Aβ plaques in Aβ-negative cases (P = 0.030). It also resulted in significantly higher between-rater agreement. The setting effect was most pronounced in the frontal lobe and in the posterior cingulate cortex/precuneus area (P = 0.005). Conclusions The early perfusion image is a suitable alternative to T1-weighted MRI to support the visual interpretation of the late Aβ image in FMM-PET.
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- author
- Mathies, Franziska L. ; Heeman, Fiona ; Visser, Pieter Jelle ; Den Braber, Anouk ; Yaqub, Maqsood ; Klutmann, Susanne ; Schöll, Michael LU ; Van De Giessen, Elsmarieke ; Collij, Lyduine E. LU and Buchert, Ralph
- organization
- publishing date
- 2024-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- amyloid PET, Centiloid, flutemetamol, perfusion, regional visual read
- in
- Clinical Nuclear Medicine
- volume
- 49
- issue
- 9
- pages
- 9 pages
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:39102811
- scopus:85200630538
- ISSN
- 0363-9762
- DOI
- 10.1097/RLU.0000000000005360
- language
- English
- LU publication?
- yes
- id
- 1c7fe32d-7391-434f-83b2-adec852f1c55
- date added to LUP
- 2024-09-03 15:38:45
- date last changed
- 2024-09-03 15:39:03
@article{1c7fe32d-7391-434f-83b2-adec852f1c55,
abstract = {{<p>Purpose Visual interpretation of brain amyloid-β (Aβ) PET can be difficult in individuals with borderline Aβ burden. Coregistration with individual MRI is recommended in these cases, which, however, is not always available. This study evaluated coregistration with the early perfusion frames acquired immediately after tracer injection to support the visual interpretation of the late Aβ-frames in PET with <sup>18</sup>F-flutemetamol (FMM). Patients and Methods Fifty dual-time-window FMM-PET scans of cognitively normal subjects with 0 to 60 Centiloids were included retrospectively (70.1 ± 6.9 years, 56% female, MMSE score 28.9 ± 1.3, 42% APOE ϵ4 carrier). Regional Aβ load was scored with respect to a 6-point Likert scale by 3 independent raters in the 10 regions of interest recommended for FMM reading using 3 different settings: Aβ image only, Aβ image coregistered with MRI, and Aβ image coregistered with the perfusion image. The impact of setting, within- and between-readers variability, region of interest, and Aβ-status was tested by repeated-measure analysis of variance of the Likert score. Results The Centiloid scale ranged between 2 and 52 (interquartile range, 7-19). Support of visual scoring by the perfusion image resulted in the best discrimination between Aβ-positive and Aβ-negative cases, mainly by improved certainty of excluding Aβ plaques in Aβ-negative cases (P = 0.030). It also resulted in significantly higher between-rater agreement. The setting effect was most pronounced in the frontal lobe and in the posterior cingulate cortex/precuneus area (P = 0.005). Conclusions The early perfusion image is a suitable alternative to T1-weighted MRI to support the visual interpretation of the late Aβ image in FMM-PET.</p>}},
author = {{Mathies, Franziska L. and Heeman, Fiona and Visser, Pieter Jelle and Den Braber, Anouk and Yaqub, Maqsood and Klutmann, Susanne and Schöll, Michael and Van De Giessen, Elsmarieke and Collij, Lyduine E. and Buchert, Ralph}},
issn = {{0363-9762}},
keywords = {{amyloid PET; Centiloid; flutemetamol; perfusion; regional visual read}},
language = {{eng}},
number = {{9}},
pages = {{838--846}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Clinical Nuclear Medicine}},
title = {{The Early Perfusion Image Is Useful to Support the Visual Interpretation of Brain Amyloid-PET With <sup>18</sup>F-Flutemetamol in Borderline Cases}},
url = {{http://dx.doi.org/10.1097/RLU.0000000000005360}},
doi = {{10.1097/RLU.0000000000005360}},
volume = {{49}},
year = {{2024}},
}