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Quantitation is however fundamental to the practice of nuclear medicine and hence can be used to supplement amyloid reading methodology especially in unclear cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 2770 [<jats:sup>18<\/jats:sup>F]flutemetamol images were collected from 3 clinical studies and 6 research cohorts with available visual reading of [<jats:sup>18<\/jats:sup>F]flutemetamol and quantitative analysis of images. These were assessed further to examine both the discordance and concordance between visual and quantitative imaging primarily using thresholds robustly established using pathology as the standard of truth. Scans covered a wide range of cases (i.e. from cognitively unimpaired subjects to patients attending the memory clinics). Methods of quantifying amyloid ranged from using CE\/510K cleared marked software (e.g. CortexID, Brass), to other research-based methods (e.g. PMOD, CapAIBL). Additionally, the clinical follow-up of two types of discordance between visual and quantitation (V+Q- and V-Q+) was examined with competing risk regression analysis to assess possible differences in prediction for progression to Alzheimer\u2019s disease (AD) and other diagnoses (OD).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Weighted mean concordance between visual and quantitation using the autopsy-derived threshold was 94% using pons as the reference region. Concordance from a sensitivity analysis which assessed the maximum agreement for each cohort using a range of cut-off values was also estimated at approximately 96% (weighted mean). Agreement was generally higher in clinical cases compared to research cases. V-Q+ discordant cases were 11% more likely to progress to AD than V+Q- for the SUVr with pons as reference region.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Quantitation of amyloid PET shows a high agreement vs binary visual reading and also allows for a continuous measure that, in conjunction with possible discordant analysis, could be used in the future to identify possible earlier pathological deposition as well as monitor disease progression and treatment effectiveness.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-021-05311-5","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T05:02:40Z","timestamp":1618203760000},"page":"2183-2199","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["A multisite analysis of the concordance between visual image interpretation and quantitative analysis of [18F]flutemetamol amyloid PET images"],"prefix":"10.1007","volume":"48","author":[{"given":"Marco","family":"Bucci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Savitcheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gill","family":"Farrar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Salvad\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyduine","family":"Collij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Dor\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Domingo","family":"Gispert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Gunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Hanseeuw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Hansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahnaz","family":"Shekari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Lhommel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Molinuevo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Rowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrille","family":"Sur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Whittington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Buckley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-5151","authenticated-orcid":false,"given":"Agneta","family":"Nordberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"5311_CR1","unstructured":"European Medicines Agency. 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Each of the studies reported was conducted with the principles of the Declaration of Helsinki, the Good Clinical Practise: Consolidated Guideline approved by the International Conference on Harmonisation and applicable national and local laws and regulations. The Ethical boards for the specific studies are listed: GE: statement of ethics compliance (and committees) in Wolk et al. 2018 []; KAROLINSKA: Ethical approval was obtained from the Regional Human Ethical Committee of Stockholm (2016-120-32); MCK: statement of ethics compliance in Sur et al. 2020 []; Le Comit\u00e9 d\u2019Ethique Hospitalo-Facultaire (CEHF) des Cliniques Universitaires Saint-Luc (CUSL) approved the project from SLC under the number UCL-2010-412 (Eudra-CT: 2011-001756-12); VU University Medical Center approved the Dutch Flutemetamol study (AUMC) (reference number: 2012\/302); Parc de Salut Mar (BBRC, Barcelona); BIOFINDER\/INVICRO (Lund Ethics Committee, Sweden); Austin Health Human Research Ethics Committee approved the AIBL study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Marco Bucci, Irina Savitcheva and Agneta Nordberg have no conflicts of interest. Gill Farrar and Chris Buckley are employees of GE Healthcare. Jos\u00e9 Luis Molinuevo and JD Gispert receive doses of [<sup>18<\/sup>F]flutemetamol for the ALFA project, a research platform to identify early pathophysiological features of Alzheimer\u2019s Disease ( identifier NCT02685969; ). Oskar Hansson receives doses of [<sup>18<\/sup>F]flutemetamol for the Biofinder project, which aims to discover key mechanisms in Alzheimer\u2019s disease, Parkinson\u2019s disease and other neurodegenerative disorders for the development of early and accurate diagnostic tests, identification of novel treatment targets and to help understand the links between different pathologies and clinical symptoms ( identifier NCT01208675). Chris Rowe received doses of [<sup>18<\/sup>F]flutemetamol for the AIBL (Australian Imaging, Biomarker and Lifestyle Flagship study set up in 2006 to which biomarkers, cognitive characteristics and health and lifestyle factors influence the development of Alzheimer\u2019s disease (). The Dutch amyloid PET utility study of Zwan et al. [] received doses of [<sup>18<\/sup>F]flutemetamol.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}