Impact of cerebral blood flow and amyloid load on SUVR bias

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  • dc.contributor.author Heeman, Fiona
  • dc.contributor.author Yaqub, Maqsood
  • dc.contributor.author Hendriks, Janine
  • dc.contributor.author van Berckel, Bart N. M.
  • dc.contributor.author Collij, Lyduine E.
  • dc.contributor.author Gray, Katherine R.
  • dc.contributor.author Manber, Richard
  • dc.contributor.author Wolz, Robin
  • dc.contributor.author Garibotto, Valentina
  • dc.contributor.author Wimberley, Catriona
  • dc.contributor.author Ritchie, Craig
  • dc.contributor.author Barkhof, Frederik
  • dc.contributor.author Gispert López, Juan Domingo
  • dc.contributor.author Vállez García, David
  • dc.contributor.author Lopes Alves, Isadora
  • dc.contributor.author Lammertsma, Adriaan A.
  • dc.contributor.author AMYPAD Consortium
  • dc.date.accessioned 2022-10-24T06:35:29Z
  • dc.date.available 2022-10-24T06:35:29Z
  • dc.date.issued 2022
  • dc.description.abstract Background: despite its widespread use, the semi-quantitative standardized uptake value ratio (SUVR) may be biased compared with the distribution volume ratio (DVR). This bias may be partially explained by changes in cerebral blood flow (CBF) and is likely to be also dependent on the extent of the underlying amyloid-β (Aβ) burden. This study aimed to compare SUVR with DVR and to evaluate the effects of underlying Aβ burden and CBF on bias in SUVR in mainly cognitively unimpaired participants. Participants were scanned according to a dual-time window protocol, with either [18F]flutemetamol (N = 90) or [18F]florbetaben (N = 31). The validated basisfunction-based implementation of the two-step simplified reference tissue model was used to derive DVR and R1 parametric images, and SUVR was calculated from 90 to 110 min post-injection, all with the cerebellar grey matter as reference tissue. First, linear regression and Bland-Altman analyses were used to compare (regional) SUVR with DVR. Then, generalized linear models were applied to evaluate whether (bias in) SUVR relative to DVR could be explained by R1 for the global cortical average (GCA), precuneus, posterior cingulate, and orbitofrontal region. Results: despite high correlations (GCA: R2 ≥ 0.85), large overestimation and proportional bias of SUVR relative to DVR was observed. Negative associations were observed between both SUVR or SUVRbias and R1, albeit non-significant. Conclusion: the present findings demonstrate that bias in SUVR relative to DVR is strongly related to underlying Aβ burden. Furthermore, in a cohort consisting mainly of cognitively unimpaired individuals, the effect of relative CBF on bias in SUVR appears limited. EudraCT Number: 2018-002277-22, registered on: 25-06-2018.
  • dc.description.sponsorship The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this project received funding from the EU/EFPIA Innovative Medicines Initiative (IMI) Joint Undertaking (EMIF grant:115372) and the EU-EFPIA IMI-2 Joint Undertaking (grant:115952). This joint undertaking receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA. This communication reflects the views of the authors and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. FB is supported by the NIHR biomedical research centre at UCLH. JDG holds a ‘Ramón y Cajal’ fellowship (RYC-2013-13054) from the Spanish Ministry of Science, Innovation and Universities. VG reports grants from the Swiss National Science Foundation (projects:320030_169876, 320030_185028 and IZSEZ0_188355) and the Velux foundation (project:1123).
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Heeman F, Yaqub M, Hendriks J, van Berckel BNM, Collij LE, Gray KR, et al. Impact of cerebral blood flow and amyloid load on SUVR bias. EJNMMI Res. 2022 May 12; 12(1): 29. DOI: 10.1186/s13550-022-00898-8.
  • dc.identifier.doi http://dx.doi.org/10.1186/s13550-022-00898-8
  • dc.identifier.issn 2191-219X
  • dc.identifier.uri http://hdl.handle.net/10230/54546
  • dc.language.iso eng
  • dc.publisher SpringerOpen
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/115372
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/115952
  • dc.rights Copyright © Heeman F, Yaqub M, Hendriks J, van Berckel BNM, Collij LE, Gray KR, 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Alzheimer’s disease
  • dc.subject.keyword Amyloid PET
  • dc.subject.keyword Cerebral blood flow
  • dc.subject.keyword Quantification
  • dc.subject.keyword SUVR bias
  • dc.title Impact of cerebral blood flow and amyloid load on SUVR bias
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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