Harmonizing florbetapir and PiB PET measurements of cortical Aβ plaque burden using multiple regions-of-interest and machine learning techniques: An alternative to the Centiloid approach

Alzheimers Dement. 2024 Mar;20(3):2165-2172. doi: 10.1002/alz.13677. Epub 2024 Jan 26.

Abstract

Introduction: Machine learning (ML) can optimize amyloid (Aβ) comparability among positron emission tomography (PET) radiotracers. Using multi-regional florbetapir (FBP) measures and ML, we report better Pittsburgh compound-B (PiB)/FBP harmonization of mean-cortical Aβ (mcAβ) than Centiloid.

Methods: PiB-FBP pairs from 92 subjects in www.oasis-brains.org and 46 in www.gaain.org/centiloid-project were used as the training/testing sets. FreeSurfer-extracted FBP multi-regional Aβ and actual PiB mcAβ in the training set were used to train ML models generating synthetic PiB mcAβ. The correlation coefficient (R) between the synthetic/actual PiB mcAβ in the testing set was assessed.

Results: In the testing set, the synthetic/actual PiB mcAβ correlation R = 0.985 (R2 = 0.970) using artificial neural network was significantly higher (p ≤ 6.6e-4) than the FBP/PiB correlation R = 0.927 (R2 = 0.860), improving total variance percentage (R2 ) from 86% to 97%. Other ML models such as partial least square, ensemble, and relevance vector regressions also improved R (p = 9.677e-05 /0.045/0.0017).

Discussion: ML improved mcAβ comparability. Additional studies are needed for the generalizability to other amyloid tracers, and to tau PET. Highlights Centiloid is a calibration of the amyloid scale, not harmonization. Centiloid unifies the amyloid scale without improving inter-tracer association (R2 ). Machine learning (ML) can harmonize the amyloid scale by improving R2 . ML harmonization maps multi-regional florbetapir SUVRs to PiB mean-cortical SUVR. Artificial neural network ML increases Centiloid R2 from 86% to 97%.

Keywords: Centiloid; PiB; amyloid PET harmonization; artificial neural network; florbetapir; machine learning.

MeSH terms

  • Alzheimer Disease* / diagnostic imaging
  • Amyloid / metabolism
  • Amyloid beta-Peptides / metabolism
  • Amyloidogenic Proteins
  • Aniline Compounds
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Ethylene Glycols
  • Humans
  • Plaque, Amyloid
  • Positron-Emission Tomography* / methods

Substances

  • florbetapir
  • Aniline Compounds
  • Ethylene Glycols
  • Amyloid
  • Amyloidogenic Proteins
  • Amyloid beta-Peptides