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Abstract
The Centiloid (CL) is a method for standardizing amyloid beta (Aβ) quantification through different ligands and methods. To find the most appropriate reference region to reduce the variance in the Aβ CL unit between 18F-florbetaben (FBB) and 18F-flutemetamol (FMM), we conducted head-to-head comparisons from 56 participants using the direct comparison of FBB-FMM CL (dcCL) method with four reference regions: cerebellar gray (CG), whole cerebellum (WC), WC with brainstem (WC + B), and pons. The FBB and FMM dcCL units were highly correlated in four reference regions: WC (R2 = 0.97), WC + B (R2 = 0.98), CG (R2 = 0.92), and pons (R2 = 0.98). WC showed the largest effect size in both FBB and FMM. Comparison of the variance of the dcCL values within the young control group showed that with FBB, WC + B had the smallest variance and with FMM, the WC had the smallest variance. Additionally, WC + B showed the smallest absolute difference between FBB and FMM, followed by the WC, pons, and CG. We found that it would be reasonable to use the WC or WC + B as the reference region when converting FBB and FMM SUVRs into dcCL, which can increase the accuracy of standardizing FBB and FMM PET results.

Affiliations

Soo Hyun Cho  1   2 , Yeong Sim Choe  1   3   4 , Seongbeom Park  1 , Young Ju Kim  1 , Hee Jin Kim  1   4 , Hyemin Jang  1   4 , Seung Joo Kim  5 , Jun Pyo Kim  1   4 , Young Hee Jung  6 , Byeong C Kim  2 , Duk L Na  1   3   4   7 , Seung Hwan Moon  8 , Sang Won Seo  9   10   11   12   13
1 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
2 Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
3 Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
4 Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
5 Department of Neurology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
6 Department of Neurology, Myoungji Hospital, Hanyang University, Goyangsi, Republic of Korea.
7 Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul, Republic of Korea.
8 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. shmoon0914@gmail.com.
9 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. sangwonseo@empal.com.
10 Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea. sangwonseo@empal.com.
11 Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. sangwonseo@empal.com.
12 Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Republic of Korea. sangwonseo@empal.com.
13 Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea. sangwonseo@empal.com.