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@ARTICLE{Bischof:905078,
author = {Bischof, Gerard Nisal and Bartenstein, Peter and Barthel,
Henryk and van Berckel, Bart and Doré, Vincent and van
Eimeren, Thilo and Foster, Norman and Hammes, Jochen and
Lammertsma, Adriaan A. and Minoshima, Satoshi and Rowe,
Chris and Sabri, Osama and Seibyl, John and Van Laere, Koen
and Vandenberghe, Rik and Villemagne, Victor and Yakushev,
Igor and Drzezga, Alexander},
title = {{T}oward a {U}niversal {R}eadout for 18 {F}-{L}abeled
{A}myloid {T}racers: {T}he {CAPTAIN}s {S}tudy},
journal = {Journal of nuclear medicine},
volume = {62},
number = {7},
issn = {0022-3123},
address = {New York, NY},
publisher = {Soc.},
reportid = {FZJ-2022-00377},
pages = {999 - 1005},
year = {2021},
abstract = {To date, 3 18F-labeled PET tracers have been approved for
assessing cerebral amyloid plaque pathology in the
diagnostic workup of suspected Alzheimer disease (AD).
Although scanning protocols are relatively similar across
tracers, U.S. Food and Drug Administration- and the European
Medicines Agency-approved visual rating protocols differ
among the 3 tracers. This proof-of-concept study assessed
the comparability of the 3 approved visual rating protocols
to classify a scan as amyloid-positive or -negative, when
applied by groups of experts and nonexperts to all 3 amyloid
tracers. Methods: In an international multicenter approach,
both expert (n = 4) and nonexpert raters (n = 3) rated scans
acquired with 18F-florbetaben, 18F-florbetapir and
18F-flutemetamol. Scans obtained with each tracer were
presented for reading according to all 3 approved visual
rating protocols. In a randomized order, every single scan
was rated by each reader according to all 3 protocols.
Raters were blinded for the amyloid tracer used and asked to
rate each scan as positive or negative, giving a confidence
judgment after each response. Percentage of visual reader
agreement, interrater reliability, and agreement of each
visual read with binary quantitative measures (fixed SUV
ratio threshold for positive or negative scans) were
computed. These metrics were analyzed separately for expert
and nonexpert groups. Results: No significant differences in
using the different approved visual rating protocols were
observed across the different metrics of agreement in the
group of experts. Nominal differences suggested that the
18F-florbetaben visual rating protocol achieved the highest
interrater reliability and accuracy especially under low
confidence conditions. For the group of nonexpert raters,
significant differences between the different visual rating
protocols were observed with overall moderate-to-fair
accuracy and with the highest reliability for the
18F-florbetapir visual rating protocol. Conclusion: We
observed high interrater agreement despite applying
different visual rating protocols for all 18F-labeled
amyloid tracers. This implies that the results of the visual
interpretation of amyloid imaging can be well standardized
and do not depend on the rating protocol in experts.
Consequently, the creation of a universal visual assessment
protocol for all amyloid imaging tracers appears feasible,
which could benefit especially the less-experienced
readers.Keywords: amyloid PET; florbetaben; florbetapir;
flutemetamol; visual rating standardization.},
cin = {INM-2},
ddc = {610},
cid = {I:(DE-Juel1)INM-2-20090406},
pnm = {5253 - Neuroimaging (POF4-525) / 5254 - Neuroscientific
Data Analytics and AI (POF4-525)},
pid = {G:(DE-HGF)POF4-5253 / G:(DE-HGF)POF4-5254},
typ = {PUB:(DE-HGF)16},
pubmed = {33712532},
UT = {WOS:000770317400004},
doi = {10.2967/jnumed.120.250290},
url = {https://juser.fz-juelich.de/record/905078},
}