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A kinetics-based approach to amyloid PET semi-quantification

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To develop and validate a semi-quantification method (time-delayed ratio, TDr) applied to amyloid PET scans, based on tracer kinetics information.

Methods

The TDr method requires two static scans per subject: one early (~ 0–10 min after the injection) and one late (typically 50–70 min or 90–100 min after the injection, depending on the tracer). High perfusion regions are delineated on the early scan and applied onto the late scan. A SUVr-like ratio is calculated between the average intensities in the high perfusion regions and the late scan hotspot. TDr was applied to a naturalistic multicenter dataset of 143 subjects acquired with [18F]florbetapir. TDr values are compared to visual evaluation, cortical–cerebellar SUVr, and to the geometrical semi-quantification method ELBA. All three methods are gauged versus the heterogeneity of the dataset.

Results

TDr shows excellent agreement with respect to the binary visual assessment (AUC = 0.99) and significantly correlates with both validated semi-quantification methods, reaching a Pearson correlation coefficient of 0.86 with respect to ELBA.

Conclusions

TDr is an alternative approach to previously validated ones (SUVr and ELBA). It requires minimal image processing; it is independent on predefined regions of interest and does not require MR registration. Besides, it takes advantage on the availability of early scans which are becoming common practice while imposing a negligible added patient discomfort.

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Funding

E.P. was supported by Airalzh Onlus—COOP Italia (grant no. 138812/Rep n° 2459). V.G. was supported by the Swiss National Science Foundation (grant no. 320030_169876) and by the Velux foundation (grant no. 1123).

Author information

Authors and Affiliations

  1. Istituto Nazionale di Fisica Nucleare (INFN), via Dodecaneso 33, I-16146, Genova, Italy

    A. Chincarini, E. Peira & M. Corosu

  2. Dept. of Neuroscience, Rehabilitation ,Ophthalmology, Genetics, Child and Maternal Health (DINOGMI), University of Genoa, Genova, Italy

    E. Peira, M. Pardini, D. Arnaldi & F. Nobili

  3. Nuclear Medicine Unit (DISSAL), University of Genoa, Genova, Italy

    S. Morbelli, M. Bauckneht & S. Capitanio

  4. Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genova, Italy

    S. Morbelli, M. Bauckneht, S. Capitanio, M. Pardini, D. Arnaldi & F. Nobili

  5. Nuclear Medicine Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy

    C. Vellani

  6. Medical Physics Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy

    D. D’Ambrosio

  7. Faculty of Medicine, University of Geneva, Geneva, Switzerland

    V. Garibotto & F. Assal

  8. Division of Nuclear Medicine and Molecular Imaging, University Hospitals of Geneva, Geneva, Switzerland

    V. Garibotto

  9. Memory Clinic, University Hospitals of Geneva, Geneva, Switzerland

    F. Assal

  10. Nuclear Medicine Unit, ASST Spedali Civili, Brescia, Italy

    B. Paghera

  11. Nuclear Medicine Unit, Fondazione Poliambulanza, Brescia, Italy

    G. Savelli, A. Stefanelli & U. P. Guerra

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  1. A. Chincarini
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  2. E. Peira
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  3. M. Corosu
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  17. F. Nobili
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Corresponding author

Correspondence to A. Chincarini.

Ethics declarations

The scans were acquired in the clinical setting for diagnostic purposes. All subjects (or their legal representative, if demented) were informed that their scans would have been used for research purposes and gave their written consent. All procedures performed were in accordance with the ethical standards of each local institutional Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The supervising ethics committee for this study is the CER (Comitato Etico della Regione Liguria), based in Genoa, Italy. Ethics Committees approvals included the transfer of imaging data, all anonymized brain amyloid PET were collected from the centers in DICOM format.

Quality of images was checked by an experienced Nuclear Medicine Physician (S.M.).

Conflict of interest

In the past years, Dr. Nobili received fees from Eli-Lilly & Co for giving teaching course on visual reading of [18F]Florbetapir, and from Bayer Pharma for participation in an advisory board on [18F]Florbetaben.

Dr. Pardini receives research support from Novartis and Nutricia and received personal fees from Novartis, Merck, Roche. Dr. Pardini is partly supported by a Curiosity-driven grant from the University of Genoa.

All other authors disclose no conflict of interest.

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Chincarini, A., Peira, E., Corosu, M. et al. A kinetics-based approach to amyloid PET semi-quantification. Eur J Nucl Med Mol Imaging 47, 2175–2185 (2020). https://doi.org/10.1007/s00259-020-04689-y

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