Centiloid scaling for quantification of brain amyloid with [ 18 F]flutemetamol using multiple processing methods

Mark R. Battle, Lovena Chedumbarum Pillay, Val J. Lowe, David Knopman, Bradley Kemp, Christopher C. Rowe, Vincent Doré, Victor L. Villemagne, Christopher J. Buckley

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Introduction: A standardised method for quantifying β-amyloid PET tracers would allow comparison across different tracers and different sites. The development of the Centiloid scale has aimed to achieve this, applying a common scale to better aid the diagnosis and prognosis of Alzheimer’s disease (AD) and to monitor anti-amyloid therapeutic interventions. Here, we apply the Centiloid method to [ 18 F]flutemetamol and [ 11 C]PiB (PiB, Pittsburgh compound B) PET images and derive the scaling factor to express their binding in Centiloids. Methods: Paired PiB and [ 18 F]flutemetamol scans for 74 subjects, including 24 young healthy controls (37 ± 5 years), were analysed using the standard Centiloid method. The same subjects were also analysed using PMOD- and FSL-based pipelines as well as SPM8. Test-retest analysis of 10 AD subjects was also performed with each pipeline. Results: The standard uptake value ratios (SUVR), determined using the standard SPM8 Centiloid process, showed a strong correlation between [ 18 F]flutemetamol (Flute) and PiB binding (SUVR-Flute = 0.77 × SUVR-PiB + 0.22, R 2 = 0.96). Application of the standard Centiloid process allowed the calculation of a direct conversion equation for SUVR-Flute to Centiloid units (CL) (CL = (121.42*SUVR-Flute) − 121.16). Analysis of the data via the two alternate Centiloid pipelines allowed us to derive standardised, SPM8-equivalent equations for both PMOD (CL = (115.24*SUVR-Flute) − 107.86) and FSL (CL = (120.32*SUVR-Flute) − 112.75) respectively. Test-retest analysis of 10 AD subjects showed an approximate 2% difference for each pipeline. Conclusions: [ 18 F]flutemetamol data can now be expressed in Centiloid units, enhancing its utility in clinical and research applications for β-amyloid imaging. The standard Centiloid method also demonstrates that [ 18 F]flutemetamol has favourable performance compared with PiB and other β-amyloid tracers. Test-retest difference averaged 2%, with no difference between image processing pipelines. Centiloid scaling is robust and can be implemented on a number of platforms.

Original languageEnglish (US)
Article number107
JournalEJNMMI Research
StatePublished - 2018

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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