RT Journal Article SR Electronic T1 Assessing Amyloid Pathology in Cognitively Normal Subjects Using 18F-Flutemetamol PET: Comparing Visual Reads and Quantitative Methods JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 541 OP 547 DO 10.2967/jnumed.118.211532 VO 60 IS 4 A1 Lyduine E. Collij A1 Elles Konijnenberg A1 Juhan Reimand A1 Mara ten Kate A1 Anouk den Braber A1 Isadora Lopes Alves A1 Marissa Zwan A1 Maqsood Yaqub A1 Daniëlle M.E. van Assema A1 Alle Meije Wink A1 Adriaan A. Lammertsma A1 Philip Scheltens A1 Pieter Jelle Visser A1 Frederik Barkhof A1 Bart N.M. van Berckel YR 2019 UL http://jnm.snmjournals.org/content/60/4/541.abstract AB Our objective was to determine the optimal approach for assessing amyloid disease in a cognitively normal elderly population. Methods: Dynamic 18F-flutemetamol PET scans were acquired using a coffee-break protocol (a 0- to 30-min scan and a 90- to 110-min scan) on 190 cognitively normal elderly individuals (mean age, 70.4 y; 60% female). Parametric images were generated from SUV ratio (SUVr) and nondisplaceable binding potential (BPND) methods, with cerebellar gray matter as a reference region, and were visually assessed by 3 trained readers. Interreader agreement was calculated using κ-statistics, and semiquantitative values were obtained. Global cutoffs were calculated for both SUVr and BPND using a receiver-operating-characteristic analysis and the Youden index. Visual assessment was related to semiquantitative classifications. Results: Interreader agreement in visual assessment was moderate for SUVr (κ = 0.57) and good for BPND images (κ = 0.77). There was discordance between readers for 35 cases (18%) using SUVr and for 15 cases (8%) using BPND, with 9 overlapping cases. For the total cohort, the mean (±SD) SUVr and BPND were 1.33 (±0.21) and 0.16 (±0.12), respectively. Most of the 35 cases (91%) for which SUVr image assessment was discordant between readers were classified as negative based on semiquantitative measurements. Conclusion: The use of parametric BPND images for visual assessment of 18F-flutemetamol in a population with low amyloid burden improves interreader agreement. Implementing semiquantification in addition to visual assessment of SUVr images can reduce false-positive classification in this population.