Whole-brain histogram analysis and top 20% gray and white matter ratio of amyloid positron emission tomography: A comparison with the centiloid scale

IF 2.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine Pub Date : 2026-05-18 DOI:10.1007/s12149-026-02218-9

Ryo Yamakuni, Shinya Seino, Anna Yamaki, Atsushi Shima, Hironobu Ishikawa, Mitsunari Abe, Harumasa Takano, Nobukatsu Sawamoto, Hirofumi Sekino, Shiro Ishii, Kenji Fukushima, Naoyuki Ukon, Takashi Kasai, Jin Narumoto, Takashi Hanakawa, Hiroshi Ito, Parkinson’s, Alzheimer’s disease Dimensional Neuroimaging Initiative (PADNI)

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引用次数: 0

Abstract

Objective

To compare whole-brain histogram analysis (WBHA) of amyloid-β (Aβ) positron emission tomography (PET) using several magnetic resonance imaging (MRI)-based brain extraction (brain extraction tool [BET]) methods, to evaluate a novel quantitative analysis method, namely the Top 20% Gray and White Matter Ratio (GW-ratio), to determine appropriate thresholds, and to evaluate diagnostic performance in comparison with the Centiloid scale (CL).

Methods

We analyzed structural MRI, ¹⁸F-flutemetamol amyloid PET images, and dementia severity scores (Global Clinical Dementia Rating [G-CDR] and Mini-Mental State Examination [MMSE]) of 262 participants. For WBHA, BET was performed using structural MRI and three different BET software programs, namely High-Definition-BET (HD-BET), FMRIB Software Library (FSL), and Statistical Parametric Mapping (SPM). Skewness and mode-to-mean ratio (MMR) were measured using brain-extracted PET. The Top 20% Map was generated from SPM BET images, separated into gray and white matter voxels, and their ratio was calculated as the GW-ratio. The CL value was computed using structural MRI. Aβ-negativity or positivity was visually determined.

Results

Skewness from three BET methods was strongly negatively correlated with CL. Skewness (HD-BET) showed the strongest correlation (R = -0.9043). Moreover, the GW-ratio strongly correlated with CL (R = 0.8332), whereas MMR, particularly MMR (FSL) (R = 0.2112), showed poor correlation. All indicators significantly distinguished Aβ-negative from Aβ-positive visuals. CL had the highest area under the curve (AUC, 0.9959), followed by skewness (HD-BET) (0.9927), Top 20% GW-ratio (0.9872), and skewness (SPM) (0.9779), with no statistical difference between CL and skewness (HD-BET) (P = 0.5763). Based on mean and SD values from 118 cognitively unimpaired (G-CDR = 0, MMSE ≥ 28) and visually Aβ-negative participants, 95% cut-off limits for Aβ-negative individuals without dementia symptoms were: CL ≤ 12.9, skewness (HD-BET) ≥ 0.1769, MMR (HD-BET) ≤ 0.9372, skewness (FSL) ≥ 0.1819, MMR (FSL) ≤ 1.9132, skewness (SPM) ≥ -0.0382, MMR (SPM) ≤ 1.1274, and GW-ratio ≤ 0.1079.

Conclusion

WBHA using MRI-based BET and GW-ratio showed strong correlations with CL and demonstrated a diagnostic performance comparable to that of CL.

Abstract Image

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淀粉样蛋白正电子发射断层扫描全脑直方图分析及前20%灰质与白质比值：与centiloid scale的比较。

目的：比较几种基于磁共振成像（MRI）的脑提取（brain extraction tool [BET]）方法对淀粉样蛋白-β (a β)正电子发射断层扫描（PET）的全脑直方图分析（WBHA）结果，评价一种新的定量分析方法，即前20%灰质和白质比（GW-ratio），确定合适的阈值，并与Centiloid scale （CL）进行比较，评价其诊断性能。方法：我们分析了262名参与者的结构MRI、18f -氟替他莫淀粉样蛋白PET图像和痴呆严重程度评分（全球临床痴呆评分[G-CDR]和迷你精神状态检查[MMSE]）。对于WBHA，使用结构MRI和三种不同的BET软件程序进行BET，即High-Definition-BET (HD-BET)， FMRIB软件库（FSL）和统计参数映射（SPM）。采用脑提取PET测量偏度和模均比（MMR）。Top 20% Map由SPM BET图像生成，分为灰质体素和白质体素，其比值计算为GW-ratio。使用结构MRI计算CL值。目测a β阴性或阳性。结果：三种BET方法的偏度与CL呈显著负相关。偏度（HD-BET）相关性最强（R = -0.9043）。gww -ratio与CL的相关性较强（R = 0.8332），而MMR尤其是MMR （FSL）的相关性较差（R = 0.2112）。所有指标均能显著区分a β阴性和a β阳性。曲线下面积最大的是CL (AUC, 0.9959)，其次是偏度（HD-BET）（0.9927）、前20% gw比（0.9872）和偏度（SPM）（0.9779）， CL与偏度（HD-BET）之间无统计学差异（P = 0.5763）。根据118名认知未受损（G-CDR = 0, MMSE≥28）和视觉a β阴性受试者的平均值和SD值，无痴呆症状的a β阴性个体的95%截断限为：CL≤12.9，偏度(HD-BET)≥0.1769,MMR (HD-BET)≤0.9372，偏度(FSL)≥0.1819,MMR (FSL)≤1.9132，偏度(SPM)≥-0.0382,MMR (SPM)≤1.1274,GW-ratio≤0.1079。结论：基于mri的BET和gw比值的WBHA与CL有很强的相关性，其诊断效果与CL相当。

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.