Impact of PET Reconstruction on Amyloid-ß Quantitation in Cross-Sectional and Longitudinal Analyses.

Amyloid-ß (Aß) accumulation in Alzheimer disease (AD) is typically measured using SUV ratio and the centiloid (CL) scale. The low spatial resolution of PET images is known to degrade quantitative metrics because of the partial-volume effect. This article examines the impact of spatial resolution, as determined by the reconstruction configuration, on the Aß PET quantitation in both cross-sectional and longitudinal data. Methods: The cross-sectional study involved 89 subjects with 20-min [18F]florbetapir scans generated on an mCT (44 Aß-negative [Aß-], 45 Aß-positive [Aß+]) using 69 reconstruction configurations, which varied in number of iteration updates, point-spread function, time-of-flight, and postreconstruction smoothing. The subjects were classified as Aß- or Aß+ visually. For each reconstruction, Aß CL was calculated using CapAIBL, and the spatial resolution was calculated as full width at half maximum (FWHM) using the barrel phantom method. The change in CLs and the effect size of the difference in CLs between Aß- and Aß+ groups with FWHM were examined. The longitudinal study involved 79 subjects (46 Aß-, 33 Aß+) with three 20-min [18F]flutemetamol scans generated on an mCT. The subjects were classified as Aß- or Aß+ using a cutoff CL of 20. All scans were reconstructed using low-, medium-, and high-resolution configurations, and Aß CLs were calculated using CapAIBL. Since linear Aß accumulation was assumed over a 10-y interval, for each reconstruction configuration, Aß accumulation rate differences (ARDs) between the second and first periods were calculated for all subjects. Zero ARD was used as a consistency metric. The number of Aß accumulators was also used to compare the sensitivity of CL across reconstruction configurations. Results: In the cross-sectional study, CLs in both the Aß- and the Aß+ groups were impacted by the FWHM of the reconstruction method. Without postreconstruction smoothing, Aß- CLs increased for a FWHM of 4.5 mm or more, whereas Aß+ CLs decreased across the FWHM range. High-resolution reconstructions provided the best statistical separation between groups. In the longitudinal study, the median ARD of low-resolution reconstructed data for the Aß- group was greater than zero whereas the ARDs of higher-resolution reconstructions were not significantly different from zero, indicating more consistent rate estimates in the higher-resolution reconstructions. Higher-resolution reconstructions identified 10 additional Aß accumulators in the Aß- group, resulting in a 22% increased group size compared with the low-resolution reconstructions. Higher-resolution reconstructions reduced the average CLs of the negative group by 12 points. Conclusion: High-resolution PET reconstructions, inherently less impacted by partial-volume effect, may improve Aß PET quantitation in both cross-sectional and longitudinal data. In the cross-sectional analysis, separation of CLs between Aß- and Aß+ cohorts increased with spatial resolution. Higher-resolution reconstructions also exhibited both improved consistency and improved sensitivity in measures of Aß accumulation. These features suggest that higher-resolution reconstructions may be advantageous in early-stage AD therapies.

Inter-scanner Aß-PET harmonization using barrel phantom spatial resolution matching.

INTRODUCTION: The standardized uptake value ratio (SUVR) is used to measure amyloid beta-positron emission tomography (Aß-PET) uptake in the brainDifferences in PET scanner technologies and image reconstruction techniques can lead to variability in PET images across scanners. This poses a challenge for Aß-PET studies conducted in multiple centers. The aim of harmonization is to achieve consistent Aß-PET measurements across different scanners. In this study, we propose an Aß-PET harmonization method of matching spatial resolution, as measured via a barrel phantom, across PET scanners. Our approach was validated using paired subject data, for which patients were imaged on multiple scanners. METHODS: In this study, three different PET scanners were evaluated: the Siemens Biograph Vision 600, Siemens Biograph molecular computed tomography (mCT), and Philips Gemini TF64. A total of five, eight, and five subjects were each scanned twice with [18F]-NAV4694 across Vision-mCT, mCT-Philips, and Vision-Philips scanner pairs. The Vision and mCT scans were reconstructed using various iterations, subsets, and post-reconstruction Gaussian smoothing, whereas only one reconstruction configuration was used for the Philips scans. The full-width at half-maximum (FWHM) of each reconstruction configuration was calculated using [18F]-filled barrel phantom scans with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) phantom analysis toolkit. Regional SUVRs were calculated from 72 brain regions using the automated anatomical labelling atlas 3 (AAL3) atlas for each subject and reconstruction configuration. Statistical similarity between SUVRs was assessed using paired (within subject) t-tests for each pair of reconstructions across scanners; the higher the p-value, the greater the similarity between the SUVRs. RESULTS: Vision-mCT harmonization: Vision reconstruction with FWHM = 4.10 mm and mCT reconstruction with FWHM = 4.30 mm gave the maximal statistical similarity (maximum p-value) between regional SUVRs. Philips-mCT harmonization: The FWHM of the Philips reconstruction was 8.2 mm and the mCT reconstruction with the FWHM of 9.35 mm, which gave the maximal statistical similarity between regional SUVRs. Philips-Vision harmonization: The Vision reconstruction with an FWHM of 9.1 mm gave the maximal statistical similarity between regional SUVRs when compared with the Philips reconstruction of 8.2 mm and were selected as the harmonized for each scanner pair. CONCLUSION: Based on data obtained from three sets of participants, each scanned on a pair of PET scanners, it has been verified that using reconstruction configurations that produce matched-barrel, phantom spatial resolutions results in maximally harmonized Aß-PET quantitation between scanner pairs. This finding is encouraging for the use of PET scanners in multi-center trials or updates during longitudinal studies. Highlights: Question: Does the process of matching the barrel phantom-derived spatial resolution between scanners harmonize amyloid beta-standardized uptake value ratio (Aß-SUVR) quantitation? Pertinent findings: It has been validated that reconstruction pairs with matched barrel phantom-derived spatial resolution maximize the similarity between subjects paired Aß-PET (positron emission tomography) SUVR values recorded on two scanners. Implications for patient care: Harmonization between scanners in multi-center trials and PET camera updates in longitudinal studies can be achieved using a simple and efficient phantom measurement procedure, beneficial for the validity of Aß-PET quantitation measurements.

Mapping the association between tau-PET and Aß-amyloid-PET using deep learning.

In Alzheimer's disease, the molecular pathogenesis of the extracellular Aß-amyloid (Aß) instigation of intracellular tau accumulation is poorly understood. We employed a high-resolution PET scanner, with low detection thresholds, to examine the Aß-tau association using a convolutional neural network (CNN), and compared results to a standard voxel-wise linear analysis. The full range of Aß Centiloid values was highly predicted by the tau topography using the CNN (training R2 = 0.86, validation R2 = 0.75, testing R2 = 0.72). Linear models based on tau-SUVR identified widespread positive correlations between tau accumulation and Aß burden throughout the brain. In contrast, CNN analysis identified focal clusters in the bilateral medial temporal lobes, frontal lobes, precuneus, postcentral gyrus and middle cingulate. At low Aß levels, information from the middle cingulate, frontal lobe and precuneus regions was more predictive of Aß burden, while at high Aß levels, the medial temporal regions were more predictive of Aß burden. The data-driven CNN approach revealed new associations between tau topography and Aß burden.

Continuous monitoring of plant sodium transport dynamics using clinical PET.

BACKGROUND: The absorption, translocation, accumulation and excretion of substances are fundamental processes in all organisms including plants, and have been successfully studied using radiotracers labelled with 11C, 13N, 14C and 22Na since 1939. Sodium is one of the most damaging ions to the growth and productivity of crops. Due to the significance of understanding sodium transport in plants, a significant number of studies have been carried out to examine sodium influx, compartmentation, and efflux using 22Na- or 24Na-labeled salts. Notably, however, most of these studies employed destructive methods, which has limited our understanding of sodium flux and distribution characteristics in real time, in live plants. Positron emission tomography (PET) has been used successfully in medical research and diagnosis for decades. Due to its ability to visualise and assess physiological and metabolic function, PET imaging has also begun to be employed in plant research. Here, we report the use of a clinical PET scanner with a 22Na tracer to examine 22Na-influx dynamics in barley plants (Hordeum vulgare L. spp. Vulgare-cultivar Bass) under variable nutrient levels, alterations in the day/night light cycle, and the presence of sodium channel inhibitors. RESULTS: 3D dynamic PET images of whole plants show readily visible 22Na translocation from roots to shoots in each examined plant, with rates influenced by both nutrient status and channel inhibition. PET images show that plants cultivated in low-nutrient media transport more 22Na than plants cultivated in high-nutrient media, and that 22Na uptake is suppressed in the presence of a cation-channel inhibitor. A distinct diurnal pattern of 22Na influx was discernible in curves displaying rates of change of relative radioactivity. Plants were found to absorb more 22Na during the light period, and anticipate the change in the light/dark cycle by adjusting the sodium influx rate downward in the dark period, an effect not previously described experimentally. CONCLUSIONS: We demonstrate the utility of clinical PET/CT scanners for real-time monitoring of the temporal dynamics of sodium transport in plants. The effects of nutrient deprivation and of ion channel inhibition on sodium influx into barley plants are shown in two proof-of-concept experiments, along with the first-ever 3D-imaging of the light and dark sodium uptake cycles in plants. This method carries significant potential for plant biology research and, in particular, in the context of genetic and treatment effects on sodium acquisition and toxicity in plants.