Centiloid recommendations for clinical context-of-use from the AMYPAD consortium

Area of Science:

• Neurology
• Nuclear Medicine
• Biomarker Research

Background:

• Alzheimer's disease (AD) diagnosis relies on detecting amyloid-beta (Aβ) pathology.
• Accurate Aβ quantification is crucial for clinical trials and patient management.
• The Centiloid (CL) scale offers a standardized, tracer-independent method for amyloid-PET quantification.

Purpose of the Study:

• To integrate existing literature and consortium data to establish clinical recommendations for the Centiloid (CL) scale.
• To define the clinical context-of-use for CL scale in Alzheimer's disease (AD) diagnosis and management.
• To highlight the utility of CL quantification in assessing Aβ pathology and guiding therapeutic decisions.

Main Methods:

• Review and integration of existing literature on Centiloid (CL) scale performance.
• Analysis of recent data from the AMYPAD consortium.
• Comparison of CL quantification with histopathology, visual reads, and cerebrospinal fluid biomarkers.

Main Results:

• Centiloid (CL) quantification robustly reflects the amount of Aβ pathology.
• CL values < 10 reliably exclude Aβ negativity, and CL values > 30 indicate Aβ positivity.
• Intermediate CL values (10-30) suggest an increased risk of disease progression.

Conclusions:

• Centiloid (CL) quantification is a valuable adjunct to visual assessment of amyloid-PET scans.
• CL quantification aids in determining eligibility for anti-amyloid therapies by assessing amyloid clearance.
• CL scale supports clinical trial design, treatment management, and identification of early Aβ pathology.