RT Journal Article
SR Electronic
T1 Assessing Amyloid Pathology in Cognitively Normal Subjects Using <sup>18</sup>F-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 Collij, Lyduine E.
A1 Konijnenberg, Elles
A1 Reimand, Juhan
A1 Kate, Mara ten
A1 Braber, Anouk den
A1 Alves, Isadora Lopes
A1 Zwan, Marissa
A1 Yaqub, Maqsood
A1 van Assema, Daniëlle M.E.
A1 Wink, Alle Meije
A1 Lammertsma, Adriaan A.
A1 Scheltens, Philip
A1 Visser, Pieter Jelle
A1 Barkhof, Frederik
A1 van Berckel, Bart N.M.
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.