Kang Yeon-Koo, Min Jae Won, Kwon Soo Jin, Ha Seunggyun
Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Division of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.
Tomography. 2025 Jul 30;11(8):86. doi: 10.3390/tomography11080086.
Despite the growing demand for amyloid PET quantification, practical challenges remain. As automated software platforms are increasingly adopted to address these limitations, we evaluated the reliability of commercial tools for Centiloid quantification against the original Centiloid Project method. This retrospective study included 332 amyloid PET scans (165 [F]Florbetaben; 167 [F]Flutemetamol) performed for suspected mild cognitive impairments or dementia, paired with T1-weighted MRI within one year. Centiloid values were calculated using three automated software platforms, BTXBrain, MIMneuro, and SCALE PET, and compared with the original Centiloid method. The agreement was assessed using Pearson's correlation coefficient, the intraclass correlation coefficient (ICC), a Passing-Bablok regression, and Bland-Altman plots. The concordance with the visual interpretation was evaluated using receiver operating characteristic (ROC) curves. BTXBrain (R = 0.993; ICC = 0.986) and SCALE PET (R = 0.992; ICC = 0.991) demonstrated an excellent correlation with the reference, while MIMneuro showed a slightly lower agreement (R = 0.974; ICC = 0.966). BTXBrain exhibited a proportional underestimation (slope = 0.872 [0.860-0.885]), MIMneuro showed a significant overestimation (slope = 1.053 [1.026-1.081]), and SCALE PET demonstrated a minimal bias (slope = 1.014 [0.999-1.029]). The bias pattern was particularly noted for FMM. All platforms maintained their trends for correlations and biases when focusing on subthreshold-to-low-positive ranges (0-50 Centiloid units). However, all platforms showed an excellent agreement with the visual interpretation (areas under ROC curves > 0.996 for all). Three automated platforms demonstrated an acceptable reliability for Centiloid quantification, although software-specific biases were observed. These differences did not impair their feasibility in aiding the image interpretation, as supported by the concordance with visual readings. Nevertheless, users should recognize the platform-specific characteristics when applying diagnostic thresholds or interpreting longitudinal changes.
尽管对淀粉样蛋白PET定量的需求不断增长，但实际挑战依然存在。随着自动化软件平台越来越多地被采用来应对这些限制，我们针对原始的Centiloid项目方法评估了用于Centiloid定量的商业工具的可靠性。这项回顾性研究纳入了332例淀粉样蛋白PET扫描（165例使用[F]氟代苯并噻唑；167例使用[F]氟代甲磺酸美金刚），这些扫描是针对疑似轻度认知障碍或痴呆进行的，并在一年内与T1加权MRI配对。使用三种自动化软件平台BTXBrain、MIMneuro和SCALE PET计算Centiloid值，并与原始的Centiloid方法进行比较。使用Pearson相关系数、组内相关系数（ICC）、Passing-Bablok回归和Bland-Altman图评估一致性。使用受试者操作特征（ROC）曲线评估与视觉解读的一致性。BTXBrain（R = 0.993；ICC = 0.986）和SCALE PET（R = 0.992；ICC = 0.991）与参考值显示出极好的相关性，而MIMneuro的一致性略低（R = 0.974；ICC = 0.966）。BTXBrain表现出成比例的低估（斜率 = 0.872 [0.860 - 0.885]），MIMneuro显示出显著高估（斜率 = 1.053 [1.026 - 1.081]），SCALE PET表现出最小偏差（斜率 = 1.014 [0.999 - 1.029]）。FMM的偏差模式尤为明显。当关注亚阈值到低阳性范围（0 - 50 Centiloid单位）时，所有平台在相关性和偏差方面都保持了各自的趋势。然而，所有平台与视觉解读都显示出极好的一致性（所有平台的ROC曲线下面积> 0.996）。三个自动化平台在Centiloid定量方面表现出可接受的可靠性，尽管观察到了软件特定的偏差。这些差异并不影响它们在辅助图像解读方面的可行性，视觉读数的一致性也证明了这一点。尽管如此，用户在应用诊断阈值或解释纵向变化时应认识到平台特定的特征。
