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Comparability of Centiloid values from [18F]flutemetamol scans using seven commercial and research software

Bollack, Ariane ; Schwarz, Adam J. ; Bourgeat, Pierrick ; Doré, Vincent ; Mejan-Fripp, Jurgen ; Page, Christopher ; Bonke, Elena ; Thurfjell, Lennart ; Hass, Michael and Balhorn, Will , et al. (2026) In Neuroimage: Reports 6(2).
Abstract

Quantification using the Centiloid (CL) scale has become a valuable information to consider when interpreting amyloid-PET images and is now implemented in several software packages. This work aims to assess the comparability of CL from [18F]flutemetamol scans derived using several research and commercial quantification pipelines. Methods: This analysis relies on three datasets: a test-retest cohort, a group of clinically relevant patients with amnestic mild cognitive impairment (aMCI) and a subgroup from the BioFINDER-1 cohort enriched with scans with amyloid loads around potential clinical decision thresholds (0-50CL). Images from the Test-Retest and aMCI cohorts were processed across seven quantification pipelines: three... (More)

Quantification using the Centiloid (CL) scale has become a valuable information to consider when interpreting amyloid-PET images and is now implemented in several software packages. This work aims to assess the comparability of CL from [18F]flutemetamol scans derived using several research and commercial quantification pipelines. Methods: This analysis relies on three datasets: a test-retest cohort, a group of clinically relevant patients with amnestic mild cognitive impairment (aMCI) and a subgroup from the BioFINDER-1 cohort enriched with scans with amyloid loads around potential clinical decision thresholds (0-50CL). Images from the Test-Retest and aMCI cohorts were processed across seven quantification pipelines: three commercial software platforms and four research tools, including the standard SPM8 workflow. The statistical analysis was based on three steps: 1) a repeatability analysis using the test-retest data; 2) a reproducibility analysis across all pipelines using the aMCI cohort; 3) an inter-software reliability analysis around three clinically relevant thresholds: 11, 25 and 37 CL using the aMCI and the BioFINDER-1 data. Results: In the Test-Retest dataset composed of 10 Alzheimer's Disease (AD) patients, high test-retest repeatability and reliability were observed with an absolute bias of less than 5 CL. Within-individual coefficients of variation ranged from 2.6 to 4.4% and repeatability coefficients from ∼8 to ∼16 CL. CL quantification was generally reproducible across pipelines in a dataset of 80 aMCI individuals (R2 in [0.94-0.99], slope in [0.98–1.03], intercept in [-4, 4], but the 95% limits of agreement (LoAs) ranged between ∼±12 and ∼±21 CL. Agreement between software around the three clinically relevant thresholds was 92-100% (kappa 0.83-1) in the aMCI data (N = 80) and 75-99% (kappa 0.48-0.96) in the BioFINDER-1 subgroup (N = 110). Conclusion: In this study, CL quantification was shown to be robust across a range of currently available software platforms. Uncertainty estimates should always be considered when interpreting results. In clinical practice, the choice of quantification software should not impact patient management decisions.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Neuroimage: Reports
volume
6
issue
2
article number
100343
publisher
Elsevier
external identifiers
  • scopus:105036266398
  • pmid:42064679
ISSN
2666-9560
DOI
10.1016/j.ynirp.2026.100343
language
English
LU publication?
yes
id
e6d2c111-c586-40d4-b1cf-0158143131fd
date added to LUP
2026-05-25 14:55:15
date last changed
2026-08-05 02:15:53
@article{e6d2c111-c586-40d4-b1cf-0158143131fd,
  abstract     = {{<p>Quantification using the Centiloid (CL) scale has become a valuable information to consider when interpreting amyloid-PET images and is now implemented in several software packages. This work aims to assess the comparability of CL from [<sup>18</sup>F]flutemetamol scans derived using several research and commercial quantification pipelines. Methods: This analysis relies on three datasets: a test-retest cohort, a group of clinically relevant patients with amnestic mild cognitive impairment (aMCI) and a subgroup from the BioFINDER-1 cohort enriched with scans with amyloid loads around potential clinical decision thresholds (0-50CL). Images from the Test-Retest and aMCI cohorts were processed across seven quantification pipelines: three commercial software platforms and four research tools, including the standard SPM8 workflow. The statistical analysis was based on three steps: 1) a repeatability analysis using the test-retest data; 2) a reproducibility analysis across all pipelines using the aMCI cohort; 3) an inter-software reliability analysis around three clinically relevant thresholds: 11, 25 and 37 CL using the aMCI and the BioFINDER-1 data. Results: In the Test-Retest dataset composed of 10 Alzheimer's Disease (AD) patients, high test-retest repeatability and reliability were observed with an absolute bias of less than 5 CL. Within-individual coefficients of variation ranged from 2.6 to 4.4% and repeatability coefficients from ∼8 to ∼16 CL. CL quantification was generally reproducible across pipelines in a dataset of 80 aMCI individuals (R<sup>2</sup> in [0.94-0.99], slope in [0.98–1.03], intercept in [-4, 4], but the 95% limits of agreement (LoAs) ranged between ∼±12 and ∼±21 CL. Agreement between software around the three clinically relevant thresholds was 92-100% (kappa 0.83-1) in the aMCI data (N = 80) and 75-99% (kappa 0.48-0.96) in the BioFINDER-1 subgroup (N = 110). Conclusion: In this study, CL quantification was shown to be robust across a range of currently available software platforms. Uncertainty estimates should always be considered when interpreting results. In clinical practice, the choice of quantification software should not impact patient management decisions.</p>}},
  author       = {{Bollack, Ariane and Schwarz, Adam J. and Bourgeat, Pierrick and Doré, Vincent and Mejan-Fripp, Jurgen and Page, Christopher and Bonke, Elena and Thurfjell, Lennart and Hass, Michael and Balhorn, Will and Nelson, Aaron and Fahmi, Rachid and Mattsson-Carlgren, Niklas and Palmqvist, Sebastian and Stomrud, Erik and Smith, Ruben and Hansson, Oskar and La Joie, Renaud and Farrar, Gill}},
  issn         = {{2666-9560}},
  language     = {{eng}},
  number       = {{2}},
  publisher    = {{Elsevier}},
  series       = {{Neuroimage: Reports}},
  title        = {{Comparability of Centiloid values from [<sup>18</sup>F]flutemetamol scans using seven commercial and research software}},
  url          = {{http://dx.doi.org/10.1016/j.ynirp.2026.100343}},
  doi          = {{10.1016/j.ynirp.2026.100343}},
  volume       = {{6}},
  year         = {{2026}},
}