阿尔茨海默病连续体中淀粉样蛋白PET扫描的百分位数定量与视觉解读之间的一致性。

Concordance between Centiloid quantification and visual interpretation of amyloid PET scans across the Alzheimer's disease continuum.

作者信息

Khalafi Mohammad, Hojjati Seyed Hani, Wang Xiuyuan H, Zhou Liangdong, Nordvig Anna S, Li Yi, Butler Tracy A, Razlighi Qolamreza R, Tanzi Emily B, Pahlajani Silky, Glodzik Lidia, Foldi Nancy S, de Leon Mony J, Chiang Gloria C

机构信息

From the Department of Radiology (MK., SHH., XHW., LZ., YL., TAB., QRR., EBT., SP., LG., NSF., MDL., GCC.), and Department of Neurology (ASN., SP.), Weill Cornell Medical Center, New York, NY, United States.

出版信息

AJNR Am J Neuroradiol. 2025 Mar 18. doi: 10.3174/ajnr.A8743.

DOI:10.3174/ajnr.A8743

PMID:40101933

Abstract

BACKGROUND AND PURPOSE

Accurate identification of cerebral beta-amyloid (Aβ) accumulation is crucial for diagnosing Alzheimer's disease (AD) and determining eligibility for anti-Aβ therapies. The Centiloid (CL) scale has emerged as a standardized method to harmonize Aβ positron emission tomography (PET) quantification across different tracers and sites. We aimed to evaluate the concordance between CL quantification and visual interpretation in a cohort of cognitively impaired (CI) and unimpaired (CU) participants who underwent Aβ PET.

MATERIALS AND METHODS

Two hundred twenty-one participants (mean age 69 ± 12.3 years) were prospectively enrolled in AD studies and underwent 247 Aβ PET scans, including 157 with [C]Pittsburgh Compound B (PiB) and 90 with [F]Florbetaben (FBB). Standardized uptake value ratios (SUVRs) were converted to the CL scale following Global Alzheimer's Association Interactive Network (GAAIN) guidelines. Percent agreement and kappa statistics were used to evaluate the concordance between CL thresholds and visual interpretation in determining Aβ positivity.

RESULTS

The highest concordance rate for the whole cohort was 93% using a CL cutoff of 18 (kappa coefficient 0.84). Using FBB, the concordance rate was highest using a CL cutoff of 24 (97%), whereas the concordance rate for PiB peaked at 94% at a CL cutoff of 18. Concordance was higher in negative than positive Aβ PET cases, 98% versus 90%. Concordance was slightly higher in CI participants, compared to CU (96% versus 93%). Disagreement commonly occurred when focal areas of Aβ positivity were identified on visual interpretation but did not meet the threshold globally by CL quantification.

CONCLUSIONS

Global CL quantification of Aβ PET scans is highly concordant with visual interpretation. Combining both methods may provide a more complete assessment of the extent of Aβ deposition in the brain.

ABBREVIATIONS

AD = Alzheimer's disease; Aβ = beta-amyloid; PET = positron emission tomography; PiB = Pittsburgh Compound B; FBB = Florbetaben; CL = Centiloid.

摘要

背景与目的

准确识别脑内β-淀粉样蛋白（Aβ）沉积对于阿尔茨海默病（AD）的诊断以及确定抗Aβ治疗的适用性至关重要。Centiloid（CL）量表已成为一种标准化方法，用于统一不同示踪剂和不同部位的Aβ正电子发射断层扫描（PET）定量分析。我们旨在评估在接受Aβ PET检查的认知受损（CI）和未受损（CU）参与者队列中，CL定量分析与视觉判读之间的一致性。

材料与方法

221名参与者（平均年龄69±12.3岁）前瞻性纳入AD研究，并接受了247次Aβ PET扫描，其中包括157次使用[C]匹兹堡化合物B（PiB）的扫描和90次使用[F]氟贝他班（FBB）的扫描。按照全球阿尔茨海默病协会互动网络（GAAIN）指南，将标准化摄取值比率（SUVRs）转换为CL量表。采用百分比一致性和kappa统计量来评估CL阈值与视觉判读在确定Aβ阳性方面的一致性。

结果

整个队列中，使用CL临界值18时一致性率最高，为93%（kappa系数0.84）。对于FBB，使用CL临界值24时一致性率最高，为97%；而对于PiB，在CL临界值18时一致性率峰值为94%。Aβ PET阴性病例的一致性高于阳性病例，分别为98%和90%。与CU参与者相比，CI参与者的一致性略高（96%对93%）。当视觉判读发现Aβ阳性的局部区域，但CL定量分析整体未达到阈值时，常出现不一致情况。