Impact of adjunctive quantitative analysis on visual interpretation of amyloid PET: a multiple tracer, multicentre study.
Adding quantitative analysis improved inter-reader agreement on amyloid positron emission tomography reads.
Impact of adjunctive quantitative analysis on visual interpretation of amyloid PET: a multiple tracer, multicentre study.
Visual amyloid positron emission tomography (positron emission tomography) interpretation is standard for detecting cerebral amyloid-β but is limited by subjectivity, inter-reader variability, and tracer heterogeneity.
This retrospective multicentre study included patients who underwent amyloid positron emission tomography with F-18 florbetaben (florbetaben), flutemetamol (flutemetamol), or florapronol (florapronol) and T1-weighted brain MRI between 2015 and 2022.
In 950 patients, adjunctive quantitative analysis significantly increased reader confidence, with high-confidence interpretations rising from 76.3% to 83.7% (p < 0.001).
Accuracy for the expert consensus adjudication increased modestly (0.930 to 0.940, p = 0.003), driven by higher specificity (0.915 to 0.944, p < 0.001) with a slight reduction in sensitivity (0.943 to 0.937, p = 0.52).
Adjunctive quantitative analysis increases reader confidence and improves inter-reader agreement in real-world amyloid positron emission tomography interpretation.
Although agreement and diagnostic metrics with expert consensus adjudication also increased, this should not be interpreted as independent diagnostic validation.
Overall, quantitative metrics appear most valuable as an adjunct to enhance consistency, particularly in equivocal cases.