Lin Huamei, Jiang Quanling, Yang Yunhao, Huang Qi, Zhang Ying, Zhang Zhengwei, Zhu Yuhua, Lu Jiaying, Wang Jing, Wang Min, Men Jianwei, Yang Yufeng, Zhang Huiwei, Guan Yihui, Ge Jingjie, Lu Jie, Jiang Jiehui, Zuo Chuantao
Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China.
Institute of Biomedical Engineering, School of Medicine, Shanghai University, Shanghai, China.
Eur J Nucl Med Mol Imaging. 2025 Apr 23. doi: 10.1007/s00259-025-07279-y.
Discrepancies between PET/CT and PET/MRI scanners can affect the determination of amyloid beta (Aβ) deposition thresholds in patients with cognitive impairment. This study aimed to identify these differences and propose a calibration method to standardize Aβ quantification across imaging modalities.
A total of 133 patients with cognitive impairment underwent Aβ PET imaging and were divided into four groups: a head-to-head PET/CT and PET/MRI cohort (group A, n = 6), an independent PET/CT cohort (group B, n = 48), an independent PET/MRI cohort (group C, n = 79), and another independent PET/MRI cohort (group D, n = 10). Standardized uptake value ratios (SUVR) of global cortical target (CTXsuvr) and centiloid (CL) values were compared within group A and between groups B and C. A whole cerebellum (WC)-referenced SUVR method was used to calibrate CL values in group C, with verification in group D.
CTXsuvr values were significantly higher in PET/MRI than in PET/CT in both group A (P < 0.05) and group C versus group B (P < 0.001). Aβ-negative/positive cases showed mean ± variance of CTXsuvr as 1.023 ± 0.104/1.479 ± 0.203 in group B and 1.146 ± 0.100/1.743 ± 0.254 in group C, with cutoffs of 1.140 (CL = 20) and 1.401 (CL = 60), respectively. WC-referenced calibration adjusted PET/MRI cutoff to 1.132 (CL = 19) in group C, aligning it with PET/CT thresholds and validated in group D.
WC-referenced SUVR calibration effectively mitigates differences in Aβ thresholds between PET/CT and PET/MRI, enhancing Aβ quantification standardization in multi-modal imaging.
PET/CT和PET/MRI扫描仪之间的差异可能会影响认知障碍患者淀粉样β蛋白（Aβ）沉积阈值的确定。本研究旨在识别这些差异，并提出一种校准方法，以实现跨成像模态的Aβ定量标准化。
共有133例认知障碍患者接受了Aβ PET成像，并被分为四组：PET/CT与PET/MRI头对头队列（A组，n = 6）、独立PET/CT队列（B组，n = 48）、独立PET/MRI队列（C组，n = 79）以及另一个独立PET/MRI队列（D组，n = 10）。比较了A组内以及B组和C组之间全脑皮质靶区标准化摄取值比率（SUVR，即CTXsuvr）和百分位数（CL）值。采用全小脑（WC）参考的SUVR方法对C组的CL值进行校准，并在D组进行验证。
在A组（P < 0.05）以及C组与B组比较（P < 0.001）中，PET/MRI的CTXsuvr值均显著高于PET/CT。Aβ阴性/阳性病例在B组中CTXsuvr的均值±方差为1.023±0.104/1.479±0.203，在C组中为1.146±0.100/1.743±0.254，截断值分别为1.140（CL = 20）和1.401（CL = 60）。WC参考校准将C组PET/MRI的截断值调整为1.132（CL = 19），使其与PET/CT阈值一致，并在D组得到验证。
WC参考的SUVR校准有效减轻了PET/CT和PET/MRI之间Aβ阈值的差异，提高了多模态成像中Aβ定量的标准化程度。
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