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This study aimed to evaluate the feasibility of integrating radiomics-enhanced\n                      <jats:sup>18<\/jats:sup>\n                      F-florbetapir positron emission tomography\/magnetic resonance imaging (\n                      <jats:sup>18<\/jats:sup>\n                      F-AV45 PET\/MRI) features for A\u03b2 status evaluation and to further explore their potential for continuous Centiloid prediction in AD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Ninety-four subjects who underwent (\n                      <jats:sup>18<\/jats:sup>\n                      F-AV45 PET\/MRI (60 A\u03b2-positive, 34 A\u03b2-negative) were retrospectively included. Standardized uptake value ratio (SUVr) features were extracted from seven cortical regions (frontal, temporal, parietal, occipital, insular, cingulate, and white matter), and corresponding T1-weighted images' radiomics features were computed. Three feature sets (PET, radiomics, and combined) were analyzed using logistic regression (LR), k-nearest neighbor (kNN), and linear discriminant analysis (LDA) with 10-fold cross-validation. The best performing model was further interpreted using SHapley Additive exPlanations (SHAP) analysis. Additionally, Centiloid regression was performed using random forest, ElasticNet, and ExtraTrees regressors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The combined feature achieved the best performance with the LR model, with area under the receiver operating characteristic curve\u2009=\u20090.9373, accuracy\u2009=\u20090.8723, F1-score\u2009=\u20090.898). SHAP analysis identified biologically meaningful features derived from both radiomics and PET modalities, showing clear inter-group separation. In Centiloid regression, the ExtraTrees model achieved strong agreement with measured values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This framework provides an interpretable and quantitative solution for amyloid evaluation, enabling both categorical A\u03b2 status discrimination and continuous Centiloid estimation from routine PET\/MRI data. This approach represents a proof-of-concept for supporting\n                      <jats:sup>18<\/jats:sup>\n                      F-AV45 PET-based assessment in AD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance statement<\/jats:title>\n                    <jats:p>This study demonstrates that radiomics-enhanced PET\/MR features can reliably predict both A\u03b2 status and Centiloid values without specialized processing platforms, offering a clinically deployable, standardized, and interpretable approach to improve AD diagnosis and monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            Radiomics-enhanced\n                            <jats:sup>18<\/jats:sup>\n                            F-AV45 PET\/MRI enabled quantitative A\u03b2 evaluation in AD.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Radiomics-enhanced\n                            <jats:sup>18<\/jats:sup>\n                            F-AV45 PET\/MRI provided a noninvasive and interpretable assessment to improve clinical confidence.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Radiomics-enhanced\n                            <jats:sup>18<\/jats:sup>\n                            F-AV45 PET\/MRI allowed Centiloid estimation without specialized platforms for wider clinical use.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41747-026-00766-3","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:01:58Z","timestamp":1781787718000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiomics-enhanced 18F-AV45 PET\/MRI for integrative assessment and centiloid estimation of amyloid-\u03b2 burden in Alzheimer\u2019s disease"],"prefix":"10.1186","volume":"10","author":[{"given":"Zengbei","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhou","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zirong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weilun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwei","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingkang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9887-5512","authenticated-orcid":false,"given":"Jun","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"766_CR1","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1016\/S0140-6736(20)32205-4","volume":"397","author":"P Scheltens","year":"2021","unstructured":"Scheltens P, De Strooper B, Kivipelto M et al (2021) Alzheimer\u2019s disease. 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