Abstract

BackgroundQuantitative evaluation of amyloid positron emission tomography (PET) with standardized uptake value ratio (SUVR) plays a key role in clinical studies of Alzheimer’s disease (AD). We have proposed a PET-only (MR-free) amyloid quantification method, although some commercial software packages are required. The aim of this study was to develop an automated quantification tool for amyloid PET without using commercial software.MethodsThe quantification tool was created by combining four components: (1) anatomical standardization to positive and negative templates using NEUROSTAT stereo.exe; (2) similarity calculation between standardized images and respective templates based on normalized cross-correlation (selection of the image for SUVR measurement); (3) voxel value normalization by the mean value of reference regions (making an SUVR-scaled image); and (4) SUVR calculation based on pre-defined regions of interest (ROIs). We examined 166 subjects who underwent a [11C] Pittsburgh compound-B PET scan through the Japanese Alzheimer’s Disease Neuroimaging Initiative (J-ADNI) study. SUVRs in five ROIs (frontal lobe, temporal lobe, parietal lobe, occipital lobe, and posterior cingulate cortex and precuneus) were calculated with the cerebellar cortex as the reference region. The SUVRs obtained by our tool were compared with manual step-by-step processing and the conventional PMOD-based method (PMOD Technologies, Switzerland).ResultsCompared with manual step-by-step processing, our developed automated quantification tool reduced processing time by 85%. The SUVRs obtained by the developed quantification tool were consistent with those obtained by manual processing. Compared with the conventional PMOD-based method, the developed quantification tool provided 1.5% lower SUVR values, on average. We determined that this bias is likely due to the difference in anatomical standardization methods.ConclusionsWe developed an automated quantification tool for amyloid PET images. Using this tool, SUVR values can be quickly measured without individual MRI and without commercial software. This quantification tool may be useful for clinical studies of AD.

Highlights

  • Quantitative evaluation of amyloid positron emission tomography (PET) with standardized uptake value ratio (SUVR) plays a key role in clinical studies of Alzheimer’s disease (AD)

  • We developed a PET-based adaptive template method, which eliminated the need for individual Magnetic resonance imaging (MRI) data

  • The developed Automated SUVR Calculation (ASC) tool is a character user interface (CUI) that runs on Windows

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Summary

Introduction

Quantitative evaluation of amyloid positron emission tomography (PET) with standardized uptake value ratio (SUVR) plays a key role in clinical studies of Alzheimer’s disease (AD). We have proposed a PET-only (MR-free) amyloid quantification method, some commercial software packages are required. The aim of this study was to develop an automated quantification tool for amyloid PET without using commercial software. Amyloid positron emission tomography (PET) visualizes the accumulation of Aβ plaque non-invasively by using tracers with analogs of Congo Red or Thioflavin T [5]. One of the first amyloid PET tracers, [11C] Pittsburgh compound-B (11C-PiB), has been widely used because of its high sensitivity and specificity [6]. Three 18Flabeled amyloid PET radiopharmaceuticals (18F-florbetapir, 18F-flutemetamol, and 18Fflorbetaben) were regulatory approved in Japan, and these amyloid PET tracers have been mainly used for clinical trials and studies of AD

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