Submit Manuscript  

Article Details


Impact of Tracer Retention Levels on Visual Analysis of Cerebral [18F]- Florbetaben Pet Images

[ Vol. 14 , Issue. 1 ]

Author(s):

Giampiero Giovacchini, Elisabetta Giovannini, Elisa Borsò, Patrizia Lazzeri, Valerio Duce, Ornella Ferrando, Franca Foppiano and Andrea Ciarmiello*   Pages 70 - 77 ( 8 )

Abstract:


Background: To compare visual and semi-quantitative analysis of brain [18F]Florbetaben PET images in Mild Cognitive Impairment (MCI) patients and relate this finding to the degree of ß-amyloid burden.

Methods: A sample of 71 amnestic MCI patients (age 74 ± 7.3 years, Mini Mental State Examination 24.2 ± 5.3) underwent cerebral [18F]Florbetaben PET/CT. Images were visually scored as positive or negative independently by three certified readers blinded to clinical and neuropsychological assessment. Amyloid positivity was also assessed by semiquantitative approach by means of a previously published threshold (SUVr ≥ 1.3). Fleiss kappa coefficient was used to compare visual analysis (after consensus among readers) and semi-quantitative analysis. Statistical significance was taken at P<0.05.

Results: After the consensus reading, 43/71 (60.6%) patients were considered positive. Cases that were interpreted as visually positive had higher SUVr than visually negative patients (1.48 ± 0.19 vs 1.11 ± 0.09) (P<0.05). Agreement between visual analysis and semi-quantitative analysis was excellent (k=0.86, P<0.05). Disagreement occurred in 7/71 patients (9.9%) (6 false positives and 1 false negative). Agreement between the two analyses was 90.0% (18/20) for SUVr < 1.1, 83% (24/29) for SUVr between 1.1 and 1.5, and 100% (22/22) for SUVr > 1.5 indicating lowest agreement for the group with intermediate amyloid burden.

Conclusion: Inter-rater agreement of visual analysis of amyloid PET images is high. Agreement between visual analysis and SUVr semi-quantitative analysis decreases in the range of 1.1< SUVr <=1.5, where the clinical scenario is more challenging.

Keywords:

PET images, cognitive impairment, Alzheimer's disease, brain PET, nuclear medicine, neurology.

Affiliation:

Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Medical Physics Unit, S. Andrea Hospital, La Spezia, Medical Physics Unit, S. Andrea Hospital, La Spezia, Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia

Graphical Abstract:



Read Full-Text article