Impact of simulated reduced injected dose on the assessment of amyloid PET scans

Young, Peter; Heeman, Fiona; Axelsson, Jan; Collij, Lyduine E.; Hitzel, Anne; Sanaat, Amirhossein; Niñerola-Baizán, Aida; Perissinotti, Andrés; Lubberink, Mark; Frisoni, Giovanni B.; Zaidi, Habib; Barkhof, Frederik; Farrar, Gill; Baker, Suzanne; Gispert López, Juan Domingo; Garibotto, Valentina; Rieckmann, Anna; Schöll, Michael; AMYPAD Consortium

Impact of simulated reduced injected dose on the assessment of amyloid PET scans

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dc.contributor.author Young, Peter
dc.contributor.author Heeman, Fiona
dc.contributor.author Axelsson, Jan
dc.contributor.author Collij, Lyduine E.
dc.contributor.author Hitzel, Anne
dc.contributor.author Sanaat, Amirhossein
dc.contributor.author Niñerola-Baizán, Aida
dc.contributor.author Perissinotti, Andrés
dc.contributor.author Lubberink, Mark
dc.contributor.author Frisoni, Giovanni B.
dc.contributor.author Zaidi, Habib
dc.contributor.author Barkhof, Frederik
dc.contributor.author Farrar, Gill
dc.contributor.author Baker, Suzanne
dc.contributor.author Gispert López, Juan Domingo
dc.contributor.author Garibotto, Valentina
dc.contributor.author Rieckmann, Anna
dc.contributor.author Schöll, Michael
dc.contributor.author AMYPAD Consortium
dc.date.accessioned 2024-10-14T06:28:05Z
dc.date.available 2024-10-14T06:28:05Z
dc.date.issued 2024
dc.description.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.
dc.description.sponsorship Open access funding provided by University of Gothenburg. 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.
dc.format.mimetype application/pdf
dc.identifier.citation Young P, Heeman F, Axelsson J, Collij LE, Hitzel A, Sanaat A, et al. Impact of simulated reduced injected dose on the assessment of amyloid PET scans. Eur J Nucl Med Mol Imaging. 2024 Feb;51(3):734-48. DOI: 10.1007/s00259-023-06481-0
dc.identifier.doi http://dx.doi.org/10.1007/s00259-023-06481-0
dc.identifier.issn 1619-7070
dc.identifier.uri http://hdl.handle.net/10230/61381
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof Eur J Nucl Med Mol Imaging. 2024 Feb;51(3):734-48
dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/115372
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/115952
dc.rights © The Author(s) 2023. 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
dc.subject.keyword Dose reduction
dc.subject.keyword Neuroimaging
dc.subject.keyword PET
dc.title Impact of simulated reduced injected dose on the assessment of amyloid PET scans
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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