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Jagust WJ, Mattay VS, Krainak DM, Wang SJ, Weidner LD, Hofling AA, Koo H, Hsieh P, Kuo PH, Farrar G, Marzella L. Quantitative Brain Amyloid PET. J Nucl Med 2024; 65:670-678. [PMID: 38514082 PMCID: PMC11064834 DOI: 10.2967/jnumed.123.265766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
Since the development of amyloid tracers for PET imaging, there has been interest in quantifying amyloid burden in the brains of patients with Alzheimer disease. Quantitative amyloid PET imaging is poised to become a valuable approach in disease staging, theranostics, monitoring, and as an outcome measure for interventional studies. Yet, there are significant challenges and hurdles to overcome before it can be implemented into widespread clinical practice. On November 17, 2022, the U.S. Food and Drug Administration, Society of Nuclear Medicine and Molecular Imaging, and Medical Imaging and Technology Alliance cosponsored a public workshop comprising experts from academia, industry, and government agencies to discuss the role of quantitative brain amyloid PET imaging in staging, prognosis, and longitudinal assessment of Alzheimer disease. The workshop discussed a range of topics, including available radiopharmaceuticals for amyloid imaging; the methodology, metrics, and analytic validity of quantitative amyloid PET imaging; its use in disease staging, prognosis, and monitoring of progression; and challenges facing the field. This report provides a high-level summary of the presentations and the discussion.
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Affiliation(s)
| | - Venkata S Mattay
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland;
| | - Daniel M Krainak
- Division of Radiological Imaging and Radiation Therapy Devices, Office of Radiological Health, Office of Product Evaluation and Quality, Centers for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland
| | - Sue-Jane Wang
- Division of Biometrics I, Office of Biostatistics, Office of Translational Sciences, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Lora D Weidner
- Division of Radiological Imaging and Radiation Therapy Devices, Office of Radiological Health, Office of Product Evaluation and Quality, Centers for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland
| | - A Alex Hofling
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Hayoung Koo
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | | | | | | | - Libero Marzella
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
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Bollack A, Collij LE, García DV, Shekari M, Altomare D, Payoux P, Dubois B, Grau‐Rivera O, Boada M, Marquié M, Nordberg A, Walker Z, Scheltens P, Schöll M, Wolz R, Schott JM, Gismondi R, Stephens A, Buckley C, Frisoni GB, Hanseeuw B, Visser PJ, Vandenberghe R, Drzezga A, Yaqub M, Boellaard R, Gispert JD, Markiewicz P, Cash DM, Farrar G, Barkhof F. Investigating reliable amyloid accumulation in Centiloids: Results from the AMYPAD Prognostic and Natural History Study. Alzheimers Dement 2024; 20:3429-3441. [PMID: 38574374 PMCID: PMC11095430 DOI: 10.1002/alz.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION To support clinical trial designs focused on early interventions, our study determined reliable early amyloid-β (Aβ) accumulation based on Centiloids (CL) in pre-dementia populations. METHODS A total of 1032 participants from the Amyloid Imaging to Prevent Alzheimer's Disease-Prognostic and Natural History Study (AMYPAD-PNHS) and Insight46 who underwent [18F]flutemetamol, [18F]florbetaben or [18F]florbetapir amyloid-PET were included. A normative strategy was used to define reliable accumulation by estimating the 95th percentile of longitudinal measurements in sub-populations (NPNHS = 101/750, NInsight46 = 35/382) expected to remain stable over time. The baseline CL threshold that optimally predicts future accumulation was investigated using precision-recall analyses. Accumulation rates were examined using linear mixed-effect models. RESULTS Reliable accumulation in the PNHS was estimated to occur at >3.0 CL/year. Baseline CL of 16 [12,19] best predicted future Aβ-accumulators. Rates of amyloid accumulation were tracer-independent, lower for APOE ε4 non-carriers, and for subjects with higher levels of education. DISCUSSION Our results support a 12-20 CL window for inclusion into early secondary prevention studies. Reliable accumulation definition warrants further investigations.
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Affiliation(s)
- Ariane Bollack
- Centre for Medical Image Computing (CMIC)Department of Medical Physics and BioengineeringUniversity College LondonLondonLondonUK
| | - Lyduine E. Collij
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
- Amsterdam Neuroscience, Brain ImagingVU University AmsterdamAmsterdamThe Netherlands
| | - David Vállez García
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall FoundationBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- Instituto de investigaciones médicas Hospital del Mar (IMIM)BarcelonaSpain
| | - Daniele Altomare
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Pierre Payoux
- Department of Nuclear MedicineImaging PoleToulouse University HospitalToulouseFrance
- Toulouse NeuroImaging CenterUniversité de ToulouseInsermUPSCHU PurpanPavillon BaudotPlace du Docteur Joseph BaylacToulouseFrance
| | - Bruno Dubois
- Department of NeurologySalpêtrière HospitalAP‐HPSorbonne UniversityParisFrance
| | - Oriol Grau‐Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall FoundationBarcelonaSpain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona – Universitat Internacional de CatalunyaBarcelonaSpain
- CIBERNEDNetwork Center for Biomedical Research in Neurodegenerative DiseasesNational Institute of Health Carlos IIIMadridSpain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona – Universitat Internacional de CatalunyaBarcelonaSpain
- CIBERNEDNetwork Center for Biomedical Research in Neurodegenerative DiseasesNational Institute of Health Carlos IIIMadridSpain
| | - Agneta Nordberg
- Department of NeurobiologyCare Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska InstitutetStockholmSweden
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska InstitutetStockholmSweden
| | - Zuzana Walker
- Division of PsychiatryUniversity College LondonLondonUK
- Essex Partnership University NHS Foundation Trust, The LodgeWickfordUK
| | - Philip Scheltens
- Alzheimer Center and Department of NeurologyAmsterdam Neuroscience, VU University Medical Center, Alzheimercentrum AmsterdamAmsterdamThe Netherlands
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine, The University of GothenburgGothenburgSweden
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University HospitalGothenburgSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
| | | | - Jonathan M. Schott
- Dementia Research Centre, UCL Queen Square Institute of NeurologyLondonUK
| | | | | | | | - Giovanni B. Frisoni
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Bernard Hanseeuw
- Department of NeurologyInstitute of Neuroscience, Université Catholique de Louvain, Cliniques Universitaires Saint‐LucBrusselsBelgium
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
- WELBIO DepartmentWEL Research InstituteWavreBelgium
| | - Pieter Jelle Visser
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Department of NeurobiologyCare Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska InstitutetStockholmSweden
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht UniversityMaastrichtThe Netherlands
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, LBI – KU Leuven Brain InstituteLeuvenBelgium
| | - Alexander Drzezga
- Department of Nuclear MedicineUniversity Hospital Cologne, Universitätsklinikums KölnKölnGermany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM‐2), Forschungszentrum Jülich GmbHJülichGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | - Maqsood Yaqub
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall FoundationBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos IIIMadridSpain
| | - Pawel Markiewicz
- Centre for Medical Image Computing (CMIC)Department of Medical Physics and BioengineeringUniversity College LondonLondonLondonUK
- Computer Science and Informatics, School of Engineering, London South Bank UniversityLondonUK
| | - David M. Cash
- Queen Square Institute of Neurology, University College LondonLondonUK
- UK Dementia Research Institute at University College LondonLondonUK
| | | | - Frederik Barkhof
- Centre for Medical Image Computing (CMIC)Department of Medical Physics and BioengineeringUniversity College LondonLondonLondonUK
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Queen Square Institute of Neurology, University College LondonLondonUK
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Young P, Heeman F, Axelsson J, Collij LE, Hitzel A, Sanaat A, Niñerola-Baizan A, Perissinotti A, Lubberink M, Frisoni GB, Zaidi H, Barkhof F, Farrar G, Baker S, Gispert JD, Garibotto V, Rieckmann A, Schöll M. Impact of simulated reduced injected dose on the assessment of amyloid PET scans. Eur J Nucl Med Mol Imaging 2024; 51:734-748. [PMID: 37897616 PMCID: PMC10796642 DOI: 10.1007/s00259-023-06481-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/15/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE To investigate the impact of reduced injected doses on the quantitative and qualitative assessment of the amyloid PET tracers [18F]flutemetamol and [18F]florbetaben. METHODS Cognitively impaired and unimpaired individuals (N = 250, 36% Aβ-positive) were included and injected with [18F]flutemetamol (N = 175) or [18F]florbetaben (N = 75). PET scans were acquired in list-mode (90-110 min post-injection) and reduced-dose images were simulated to generate images of 75, 50, 25, 12.5 and 5% of the original injected dose. Images were reconstructed using vendor-provided reconstruction tools and visually assessed for Aβ-pathology. SUVRs were calculated for a global cortical and three smaller regions using a cerebellar cortex reference tissue, and Centiloid was computed. Absolute and percentage differences in SUVR and CL were calculated between dose levels, and the ability to discriminate between Aβ- and Aβ + scans was evaluated using ROC analyses. Finally, intra-reader agreement between the reduced dose and 100% images was evaluated. RESULTS At 5% injected dose, change in SUVR was 3.72% and 3.12%, with absolute change in Centiloid 3.35CL and 4.62CL, for [18F]flutemetamol and [18F]florbetaben, respectively. At 12.5% injected dose, percentage change in SUVR and absolute change in Centiloid were < 1.5%. AUCs for discriminating Aβ- from Aβ + scans were high (AUC ≥ 0.94) across dose levels, and visual assessment showed intra-reader agreement of > 80% for both tracers. CONCLUSION This proof-of-concept study showed that for both [18F]flutemetamol and [18F]florbetaben, adequate quantitative and qualitative assessments can be obtained at 12.5% of the original injected dose. However, decisions to reduce the injected dose should be made considering the specific clinical or research circumstances.
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Affiliation(s)
- Peter Young
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Physiology and Neuroscience, University of Gothenburg, Gothenburg, Sweden
| | - Fiona Heeman
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Physiology and Neuroscience, University of Gothenburg, Gothenburg, Sweden
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Jan Axelsson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Lyduine E Collij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Anne Hitzel
- Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France
| | - Amirhossein Sanaat
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Aida Niñerola-Baizan
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), ISCIII, Barcelona, Spain
| | - Andrés Perissinotti
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), ISCIII, Barcelona, Spain
| | - Mark Lubberink
- Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
- Geneva University Neurocenter, Geneva University, Geneva, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- UCL Institute of Neurology, London, UK
| | | | - Suzanne Baker
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, United States
| | - Juan Domingo Gispert
- Barcelona βeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, University Hospitals of Geneva; NIMTLab; Center for Biomedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - Anna Rieckmann
- Institute for Psychology, Universität Der Bundeswehr München, Neubiberg, Germany
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
- Department of Psychiatry and Neurochemistry, Institute of Physiology and Neuroscience, University of Gothenburg, Gothenburg, Sweden.
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Cerina V, Crivellaro C, Morzenti S, Pozzi FE, Bigiogera V, Jonghi-Lavarini L, Moresco RM, Basso G, De Bernardi E. A ROI-based quantitative pipeline for 18F-FDG PET metabolism and pCASL perfusion joint analysis: Validation of the 18F-FDG PET line. Heliyon 2024; 10:e23340. [PMID: 38163125 PMCID: PMC10755331 DOI: 10.1016/j.heliyon.2023.e23340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024] Open
Abstract
In Mild Cognitive Impairment (MCI), the study of brain metabolism, provided by 18F-FluoroDeoxyGlucose Positron Emission Tomography (18F-FDG PET) can be integrated with brain perfusion through pseudo-Continuous Arterial Spin Labeling Magnetic Resonance sequences (MR pCASL). Cortical hypometabolism identification generally relies on wide control group datasets; pCASL control groups are instead not publicly available yet, due to lack of standardization in the acquisition parameters. This study presents a quantitative pipeline to be applied to PET and pCASL data to coherently analyze metabolism and perfusion inside 16 matching cortical regions of interest (ROIs) derived from the AAL3 atlas. The PET line is tuned on 36 MCI patients and 107 healthy control subjects, to agree in identifying hypometabolic regions with clinical reference methods (visual analysis supported by a vendor tool and Statistical Parametric Mapping, SPM, with two parametrizations here identified as SPM-A and SPM-B). The analysis was conducted for each ROI separately. The proposed PET analysis pipeline obtained accuracy 78 % and Cohen's к 60 % vs visual analysis, accuracy 79 % and Cohen's к 58 % vs SPM-A, accuracy 77 % and Cohen's к 54 % vs SPM-B. Cohen's к resulted not significantly different from SPM-A and SPM-B Cohen's к when assuming visual analysis as reference method (p-value 0.61 and 0.31 respectively). Considering SPM-A as reference method, Cohen's к is not significantly different from SPM-B Cohen's к as well (p-value = 1.00). The complete PET-pCASL pipeline was then preliminarily applied on 5 MCI patients and metabolism-perfusion regional correlations were assessed. The proposed approach can be considered as a promising tool for PET-pCASL joint analyses in MCI, even in the absence of a pCASL control group, to perform metabolism-perfusion regional correlation studies, and to assess and compare perfusion in hypometabolic or normo-metabolic areas.
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Affiliation(s)
- Valeria Cerina
- PhD program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Cinzia Crivellaro
- Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Sabrina Morzenti
- Medical Physics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Federico E. Pozzi
- PhD program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Italy
- Neurology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
- Milan center for Neuroscience (NeuroMI), University of Milano-Bicocca, Italy
| | | | | | - Rosa M. Moresco
- School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Gianpaolo Basso
- Milan center for Neuroscience (NeuroMI), University of Milano-Bicocca, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Italy
- Neuroradiology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
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Liu S, Maruff P, Fedyashov V, Masters CL, Goudey B. A Data-Driven Cognitive Composite Sensitive to Amyloid-β for Preclinical Alzheimer's Disease. J Alzheimers Dis 2024; 101:889-899. [PMID: 39269831 DOI: 10.3233/jad-231319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Background Integrating scores from multiple cognitive tests into a single cognitive composite has been shown to improve sensitivity to detect AD-related cognitive impairment. However, existing composites have little sensitivity to amyloid-β status (Aβ +/-) in preclinical AD. Objective Evaluate whether a data-driven approach for deriving cognitive composites can improve the sensitivity to detect Aβ status among cognitively unimpaired (CU) individuals compared to existing cognitive composites. Methods Based on the data from the Anti-Amyloid Treatment in the Asymptomatic Alzheimer's Disease (A4) study, a novel composite, the Data-driven Preclinical Alzheimer's Cognitive Composite (D-PACC), was developed based on test scores and response durations selected using a machine learning algorithm from the Cogstate Brief Battery (CBB). The D-PACC was then compared with conventional composites in the follow-up A4 visits and in individuals from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Result The D-PACC showed a comparable or significantly higher ability to discriminate Aβ status [median Cohen's d = 0.172] than existing composites at the A4 baseline visit, with similar results at the second visit. The D-PACC demonstrated the most consistent sensitivity to Aβ status in both A4 and ADNI datasets. Conclusions The D-PACC showed similar or improved sensitivity when screening for Aβ+ in CU populations compared to existing composites but with higher consistency across studies.
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Affiliation(s)
- Shu Liu
- ARC Training Centre in Cognitive Computing for Medical Technologies, University of Melbourne, Carlton, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- CogState Ltd, Melbourne, VIC, Australia
| | - Victor Fedyashov
- ARC Training Centre in Cognitive Computing for Medical Technologies, University of Melbourne, Carlton, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Colin L Masters
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Benjamin Goudey
- ARC Training Centre in Cognitive Computing for Medical Technologies, University of Melbourne, Carlton, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
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Bollack A, Markiewicz PJ, Wink AM, Prosser L, Lilja J, Bourgeat P, Schott JM, Coath W, Collij LE, Pemberton HG, Farrar G, Barkhof F, Cash DM. Evaluation of novel data-driven metrics of amyloid β deposition for longitudinal PET studies. Neuroimage 2023; 280:120313. [PMID: 37595816 DOI: 10.1016/j.neuroimage.2023.120313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/29/2023] [Accepted: 08/04/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE Positron emission tomography (PET) provides in vivo quantification of amyloid-β (Aβ) pathology. Established methods for assessing Aβ burden can be affected by physiological and technical factors. Novel, data-driven metrics have been developed to account for these sources of variability. We aimed to evaluate the performance of four of these amyloid PET metrics against conventional techniques, using a common set of criteria. METHODS Three cohorts were used for evaluation: Insight 46 (N=464, [18F]florbetapir), AIBL (N=277, [18F]flutemetamol), and an independent test-retest data (N=10, [18F]flutemetamol). Established metrics of amyloid tracer uptake included the Centiloid (CL) and where dynamic data was available, the non-displaceable binding potential (BPND). The four data-driven metrics computed were the amyloid load (Aβ load), the Aβ-PET pathology accumulation index (Aβ index), the Centiloid derived from non-negative matrix factorisation (CLNMF), and the amyloid pattern similarity score (AMPSS). These metrics were evaluated using reliability and repeatability in test-retest data, associations with BPND and CL, variability of the rate of change and sample size estimates to detect a 25% slowing in Aβ accumulation. RESULTS All metrics showed good reliability. Aβ load, Aβ index and CLNMF were strong associated with the BPND. The associations with CL suggest that cross-sectional measures of CLNMF, Aβ index and Aβ load are robust across studies. Sample size estimates for secondary prevention trial scenarios were the lowest for CLNMF and Aβ load compared to the CL. CONCLUSION Among the novel data-driven metrics evaluated, the Aβ load, the Aβ index and the CLNMF can provide comparable performance to more established quantification methods of Aβ PET tracer uptake. The CLNMF and Aβ load could offer a more precise alternative to CL, although further studies in larger cohorts should be conducted.
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Affiliation(s)
- Ariane Bollack
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK.
| | - Pawel J Markiewicz
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - Alle Meije Wink
- Amsterdam UMC, location VUmc, Department of Radiology and Nuclear Medicine, Amsterdam, the Netherlands
| | - Lloyd Prosser
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | | | | | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - William Coath
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Lyduine E Collij
- Amsterdam UMC, location VUmc, Department of Radiology and Nuclear Medicine, Amsterdam, the Netherlands; Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Hugh G Pemberton
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK; GE HealthCare, Amersham, UK; Queen Square Institute of Neurology, University College London, UK
| | | | - Frederik Barkhof
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK; Amsterdam UMC, location VUmc, Department of Radiology and Nuclear Medicine, Amsterdam, the Netherlands; Queen Square Institute of Neurology, University College London, UK
| | - David M Cash
- Queen Square Institute of Neurology, University College London, UK; UK Dementia Research Institute at University College London, London, UK
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7
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Bourgeat P, Doré V, Rowe CC, Benzinger T, Tosun D, Goyal MS, LaMontagne P, Jin L, Weiner MW, Masters CL, Fripp J, Villemagne VL. A universal neocortical mask for Centiloid quantification. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12457. [PMID: 37492802 PMCID: PMC10363815 DOI: 10.1002/dad2.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/22/2023] [Accepted: 06/21/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION The Centiloid (CL) project was developed to harmonize the quantification of amyloid beta (Aβ) positron emission tomography (PET) scans to a unified scale. The CL neocortical mask was defined using 11C Pittsburgh compound B (PiB), overlooking potential differences in regional distribution among Aβ tracers. We created a universal mask using an independent dataset of five Aβ tracers, and investigated its impact on inter-tracer agreement, tracer variability, and group separation. METHODS Using data from the Alzheimer's Dementia Onset and Progression in International Cohorts (ADOPIC) study (Australian Imaging Biomarkers and Lifestyle + Alzheimer's Disease Neuroimaging Initiative + Open Access Series of Imaging Studies), age-matched pairs of mild Alzheimer's disease (AD) and healthy controls (HC) were selected: 18F-florbetapir (N = 147 pairs), 18F-florbetaben (N = 22), 18F-flutemetamol (N = 10), 18F-NAV (N = 42), 11C-PiB (N = 63). The images were spatially and standardized uptake value ratio normalized. For each tracer, the mean AD-HC difference image was thresholded to maximize the overlap with the standard neocortical mask. The universal mask was defined as the intersection of all five masks. It was evaluated on the Global Alzheimer's Association Interactive Network (GAAIN) head-to-head datasets in terms of inter-tracer agreement and variance in the young controls (YC) and on the ADOPIC dataset comparing separation between HC/AD and HC/mild cognitive impairment (MCI). RESULTS In the GAAIN dataset, the universal mask led to a small reduction in the variance of the YC, and a small increase in the inter-tracer agreement. In the ADOPIC dataset, it led to a better separation between HC/AD and HC/MCI at baseline. DISCUSSION The universal CL mask led to an increase in inter-tracer agreement and group separation. Those increases were, however, very small, and do not provide sufficient benefits to support departing from the existing standard CL mask, which is suitable for the quantification of all Aβ tracers. HIGHLIGHTS This study built an amyloid universal mask using a matched cohort for the five most commonly used amyloid positron emission tomography tracers.There was a high overlap between each tracer-specific mask.Differences in quantification and group separation between the standard and universal mask were small.The existing standard Centiloid mask is suitable for the quantification of all amyloid beta tracers.
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Affiliation(s)
- Pierrick Bourgeat
- Australian eHealth Research CentreCSIRO Health and BiosecurityBrisbaneQueenslandAustralia
| | - Vincent Doré
- Australian eHealth Research CentreCSIRO Health and BiosecurityBrisbaneQueenslandAustralia
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
| | - Christopher C. Rowe
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthUniversity of Melbourne, ParkvilleMelbourneVictoriaAustralia
| | - Tammie Benzinger
- Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Duygu Tosun
- San Francisco Veterans Affairs Medical CenterSan FranciscoCaliforniaUSA
- Department of Radiology and Biomedical ImagingUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Manu S. Goyal
- Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisMissouriUSA
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Pamela LaMontagne
- Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Liang Jin
- The Florey Institute of Neuroscience and Mental HealthUniversity of Melbourne, ParkvilleMelbourneVictoriaAustralia
| | - Michael W. Weiner
- San Francisco Veterans Affairs Medical CenterSan FranciscoCaliforniaUSA
- Department of Radiology and Biomedical ImagingUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Colin L. Masters
- The Florey Institute of Neuroscience and Mental HealthUniversity of Melbourne, ParkvilleMelbourneVictoriaAustralia
| | - Jurgen Fripp
- Australian eHealth Research CentreCSIRO Health and BiosecurityBrisbaneQueenslandAustralia
| | - Victor L. Villemagne
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- Department of PsychiatryThe University of PittsburghPittsburghPennsylvaniaUSA
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Bilgel M. Probabilistic estimation for across-batch compatibility enhancement for amyloid PET. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12436. [PMID: 37424963 PMCID: PMC10323321 DOI: 10.1002/dad2.12436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/20/2023] [Accepted: 04/10/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION It is necessary to accurately account for systematic differences due to variability in scanners, radiotracers, and acquisition protocols in multisite studies combining amyloid imaging data. METHODS We propose Probabilistic Estimation for Across-batch Compatibility Enhancement (PEACE), a fully Bayesian multimodal extension of the widely used ComBat harmonization model, and we apply it to harmonize regional amyloid positron emission tomography data from two scanners. RESULTS Simulations show that PEACE recovers true harmonized values better than ComBat, even for unimodal data. PEACE harmonization of multiscanner regional amyloid imaging data yields results that agree better with longitudinal data compared to ComBat, without removing the known biological effects of age or apolipoprotein E genotype. DISCUSSION PEACE outperforms ComBat in both unimodal and bimodal contexts, is applicable to multisite amyloid imaging data, and holds promise for the harmonization of other neuroimaging data over ComBat. HIGHLIGHTS We introduce PEACE, a fully Bayesian multimodal extension of ComBat harmonization.Simulations show that PEACE recovers true harmonized values better than ComBat.PEACE accurately harmonizes multiscanner regional amyloid imaging data.
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Affiliation(s)
- Murat Bilgel
- Laboratory of Behavioral NeuroscienceNational Institute on AgingBaltimoreMarylandUSA
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Balaji N, Balachandar R, Algodayan S, Lilburn DML, Fraioli F, Bomanji JB. New impetus for amyloid-PET imaging following the Food and Drug administration approval of a new Alzheimer's disease treatment. Nucl Med Commun 2023; 44:415-416. [PMID: 36942553 DOI: 10.1097/mnm.0000000000001688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Affiliation(s)
- Nikita Balaji
- Department of Imaging, Institute of Nuclear Medicine, University College London Hospital, London, UK
| | - Ramya Balachandar
- Department of Imaging, Institute of Nuclear Medicine, University College London Hospital, London, UK
| | - Sarah Algodayan
- Department of Imaging, Institute of Nuclear Medicine, University College London Hospital, London, UK
- Department of Radiology, Imam Abdulrahman Bin Faisal University Hospital, Dammam, Saudi Arabia
| | - David M L Lilburn
- Department of Imaging, Institute of Nuclear Medicine, University College London Hospital, London, UK
- Department of Imaging, School of Medicine, University College London, London, UK
| | - Francesco Fraioli
- Department of Imaging, Institute of Nuclear Medicine, University College London Hospital, London, UK
- Department of Imaging, School of Medicine, University College London, London, UK
| | - Jamshed B Bomanji
- Department of Imaging, Institute of Nuclear Medicine, University College London Hospital, London, UK
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10
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Coath W, Modat M, Cardoso MJ, Markiewicz PJ, Lane CA, Parker TD, Keshavan A, Buchanan SM, Keuss SE, Harris MJ, Burgos N, Dickson J, Barnes A, Thomas DL, Beasley D, Malone IB, Wong A, Erlandsson K, Thomas BA, Schöll M, Ourselin S, Richards M, Fox NC, Schott JM, Cash DM. Operationalizing the centiloid scale for [ 18F]florbetapir PET studies on PET/MRI. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12434. [PMID: 37201176 PMCID: PMC10186069 DOI: 10.1002/dad2.12434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/03/2023] [Accepted: 02/19/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION The Centiloid scale aims to harmonize amyloid beta (Aβ) positron emission tomography (PET) measures across different analysis methods. As Centiloids were created using PET/computerized tomography (CT) data and are influenced by scanner differences, we investigated the Centiloid transformation with data from Insight 46 acquired with PET/magnetic resonanceimaging (MRI). METHODS We transformed standardized uptake value ratios (SUVRs) from 432 florbetapir PET/MRI scans processed using whole cerebellum (WC) and white matter (WM) references, with and without partial volume correction. Gaussian-mixture-modelling-derived cutpoints for Aβ PET positivity were converted. RESULTS The Centiloid cutpoint was 14.2 for WC SUVRs. The relationship between WM and WC uptake differed between the calibration and testing datasets, producing implausibly low WM-based Centiloids. Linear adjustment produced a WM-based cutpoint of 18.1. DISCUSSION Transformation of PET/MRI florbetapir data to Centiloids is valid. However, further understanding of the effects of acquisition or biological factors on the transformation using a WM reference is needed. HIGHLIGHTS Centiloid conversion of amyloid beta positron emission tomography (PET) data aims to standardize results.Centiloid values can be influenced by differences in acquisition.We converted florbetapir PET/magnetic resonance imaging data from a large birth cohort.Whole cerebellum referenced values could be reliably transformed to Centiloids.White matter referenced values may be less generalizable between datasets.
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Affiliation(s)
- William Coath
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Marc Modat
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - M. Jorge Cardoso
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Pawel J. Markiewicz
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUCLLondonUK
| | | | - Thomas D. Parker
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Ashvini Keshavan
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Sarah M. Buchanan
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Sarah E. Keuss
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Matthew J. Harris
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Ninon Burgos
- Sorbonne Université, Institut du Cerveau ‐ Paris Brain Institute ‐ ICM, Inserm, CNRS, AP‐HP, Hôpital Pitié Salpêtrière, InriaAramis project‐teamParisFrance
| | - John Dickson
- Institute of Nuclear MedicineUniversity College London HospitalsLondonUK
| | - Anna Barnes
- Institute of Nuclear MedicineUniversity College London HospitalsLondonUK
| | - David L. Thomas
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- Department of Brain Repair and RehabilitationUCL Queen Square Institute of NeurologyLondonUK
- Wellcome Centre for Human Neuroimaging, Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Daniel Beasley
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Ian B. Malone
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK
| | - Kjell Erlandsson
- Institute of Nuclear MedicineUniversity College London HospitalsLondonUK
| | - Benjamin A. Thomas
- Institute of Nuclear MedicineUniversity College London HospitalsLondonUK
| | - Michael Schöll
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska AcademyUniversity of GothenburgMölndalSweden
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgMölndalSweden
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | | | - Nick C. Fox
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- Dementia Research InstituteUCL Queen Square Institute of NeurologyLondonUK
| | | | - David M. Cash
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUCLLondonUK
- Dementia Research InstituteUCL Queen Square Institute of NeurologyLondonUK
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Chen Z, Liu Y, Zhang Y, Li Q. Orthogonal latent space learning with feature weighting and graph learning for multimodal Alzheimer's disease diagnosis. Med Image Anal 2023; 84:102698. [PMID: 36462372 DOI: 10.1016/j.media.2022.102698] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/18/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
Recent studies have shown that multimodal neuroimaging data provide complementary information of the brain and latent space-based methods have achieved promising results in fusing multimodal data for Alzheimer's disease (AD) diagnosis. However, most existing methods treat all features equally and adopt nonorthogonal projections to learn the latent space, which cannot retain enough discriminative information in the latent space. Besides, they usually preserve the relationships among subjects in the latent space based on the similarity graph constructed on original features for performance boosting. However, the noises and redundant features significantly corrupt the graph. To address these limitations, we propose an Orthogonal Latent space learning with Feature weighting and Graph learning (OLFG) model for multimodal AD diagnosis. Specifically, we map multiple modalities into a common latent space by orthogonal constrained projection to capture the discriminative information for AD diagnosis. Then, a feature weighting matrix is utilized to sort the importance of features in AD diagnosis adaptively. Besides, we devise a regularization term with learned graph to preserve the local structure of the data in the latent space and integrate the graph construction into the learning processing for accurately encoding the relationships among samples. Instead of constructing a similarity graph for each modality, we learn a joint graph for multiple modalities to capture the correlations among modalities. Finally, the representations in the latent space are projected into the target space to perform AD diagnosis. An alternating optimization algorithm with proved convergence is developed to solve the optimization objective. Extensive experimental results show the effectiveness of the proposed method.
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Affiliation(s)
- Zhi Chen
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yongguo Liu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Yun Zhang
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Qiaoqin Li
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China
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