TY - JOUR 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 SP - 541 LP - 547 DO - 10.2967/jnumed.118.211532 VL - 60 IS - 4 AU - Lyduine E. Collij AU - Elles Konijnenberg AU - Juhan Reimand AU - Mara ten Kate AU - Anouk den Braber AU - Isadora Lopes Alves AU - Marissa Zwan AU - Maqsood Yaqub AU - Daniëlle M.E. van Assema AU - Alle Meije Wink AU - Adriaan A. Lammertsma AU - Philip Scheltens AU - Pieter Jelle Visser AU - Frederik Barkhof AU - Bart N.M. van Berckel Y1 - 2019/04/01 UR - http://jnm.snmjournals.org/content/60/4/541.abstract N2 - 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. ER -