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Amyloid PET quantification using low-dose CT-guided anatomic standardization.

Hiroshi Matsuda1,2,3,4, Tensho Yamao5,6, Mitsuru Shakado7

  • 1Department of Biofunctional Imaging, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan. hiroshi.matsuda@mt.strins.or.jp.

EJNMMI Research
|December 14, 2021
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Summary
This summary is machine-generated.

Low-dose CT can substitute for MRI in amyloid PET imaging for Centiloid (CL) scaling. While CT shows a slight underestimation, it maintains high correlation, enabling accurate CL measurement without MRI.

Keywords:
Alzheimer’s diseaseAmyloid imagingCentiloid scaleComputed tomographyMagnetic resonance imagingPositron emission tomography

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Area of Science:

  • Neuroimaging
  • Nuclear Medicine
  • Radiology

Background:

  • Centiloid (CL) scaling is a standardized measure for amyloid PET, crucial for comparing results across institutions.
  • Accurate CL calculation requires anatomic standardization using coregistered MRI, which is not always available.
  • Low-dose CT (LDCT) is used for PET attenuation correction and may serve as an MRI alternative for CL scaling.

Purpose of the Study:

  • To evaluate the substitutability of LDCT for MRI in the anatomic standardization process for CL scale calculation.
  • To assess the measurement accuracy of CL scale derived from LDCT compared to MRI in amyloid PET.
  • To investigate regional differences in CT-based versus MRI-based standardized images.

Main Methods:

  • Amyloid PET images (18F-flutemetamol) from 24 Alzheimer's disease patients were analyzed.
  • CL scale was calculated using both 3D T1-weighted MRI (CLMRI) and LDCT (CLCT) for anatomic standardization.
  • Statistical analyses included Bland-Altman plots, Pearson correlation, and linear regression to compare CLCT and CLMRI.

Main Results:

  • CLCT was slightly but significantly underestimated compared to CLMRI (mean difference -1.7 ± 2.4, p < 0.002).
  • A highly significant correlation (r = 0.998, p < 0.001) was found between CLCT and CLMRI.
  • Linear regression showed CLMRI = 1.027 × CLCT + 0.762, with no significant association between the difference and CL load.

Conclusions:

  • Low-dose CT of PET/CT can effectively substitute for MRI in anatomic standardization for amyloid PET CL scale calculation.
  • Despite a slight underestimation, LDCT provides accurate and highly correlated results, enhancing accessibility to CL scaling.
  • This finding supports the broader application of CL scaling in clinical practice and research, even when MRI is unavailable.