Standardization of amyloid quantitation with 18F-Florbetapir SUV ratio to the Centiloid scale and its application in Chinese Preclinical Alzheimer's Disease Study
Objective To standardize the quantitation of 18F-Florbetapir PET SUV ratio(SUVR)to the Centiloid(CL)scale,and analyze the positive rate of β-amyloid(Aβ)in Chinese Preclinical Alzheimer's Disease(AD)Study(C-PAS).Methods 11C-Pittsburgh compound B(PIB)and 18F-Florbetapir images from public databases"Standard PIB"and"Florbetapir Calibration"were preprocessed by statistical para-metric mapping(SPM)12,and the transformative formulas from SUVR to CL were derived.Then a total of 942 subjects(357 males,585 females;age(66.4±8.1)years)from C-PAS who received 18F-Florbetapir PET at the Department of Nuclear Medicine & PET Center,Huashan Hospital,Fudan University from October 2018 to August 2023 were retrospectively included.CL values were calculated and the Aβ positive rates(CL value≤ 12,Aβ negative;12＜CL value＜30,Aβ subtle pathology;CL value≥30,Aβ positive)of AD,mild cognitive impairment(MCI)and cognitive unimpaired(CU)groups were explored.Data were analyzed by using Kruskal-Wallis rank sum test,Dunn's test(Bonferroni correction)and x2 test.Results The formula for the 18F-Florbetapir SUVR converted to CL was CL=179.64xSUVR_Florbetapir-186.95.In the C-PAS cohort,the SUVR,CL value,Aβ positive rate(including subtle pathology)of patients with clinically diag-nosed AD were 1.29±0.22,43.97±39.23,71.80％(140/195),which were 1.04(1.02,1.14),1.16(-4.04,17.14),28.50％(61/214)for patients with MCI,and 1.04(1.01,1.08),0.54(-5.29,7.69),15.38％(82/533)for CU subjects,respectively.SUVR,CL value and the ratio of negative,subtle and positive Aβpathology of the above three groups exhibited statistical differences(H=148.30,H=148.30,x2=262.12,all P＜0.001).Besides,mixed MCI group exhibited higher CL values((2.45(-1.54,46.32)vs-1.58(-6.33,7.20);H=8.21,P=0.016;z=2.81,P=0.015)and Aβ positive rate(including subtle pathology)(41.18％(14/34)vs 14.64％(6/41);x2 values:12.71 and 10.63,both P＜0.01),compared to non-amnestic MCI group.The CL values and Aβ positive rates were also increased with age in CU group.Conclusion This study validates the feasibility of the CL formula with 18F-Florbetapir images and reveals Aβ deposition in C-PAS cohort,which can lay the foundation for multi-center Aβ PET studies in China.
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