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Centiloid recommendations for clinical context-of-use from the AMYPAD consortium

Collij LE, Bollack A, La Joie R, Shekari M, Bullich S, Roé-Vellvé N, Koglin N, Jovalekic A, Garciá DV, Drzezga A, Garibotto V, Stephens AW, Battle M, Buckley C, Barkhof F, Farrar G, Gispert JD

Resum

Amyloid-PET quantification through the tracer-independent Centiloid (CL) scale has emerged as an essential tool for the accurate measurement of amyloid-β (Aβ) pathology in Alzheimer's disease (AD) patients. The AMYPAD consortium set out to integrate existing literature and recent work from the consortium to provide clinical context-of-use recommendations for the CL scale. Compared to histopathology, visual reads, and cerebrospinal fluid, CL quantification accurately reflects the amount of AD pathology. With high certainty, a CL value below 10 excludes the presence of Aβ pathology, while a value above 30 corresponds well with pathological amounts. Values falling in between these two cutoffs ("intermediate range") are related to an increased risk of disease progression. Together, CL quantification is a valuable adjunct to visual assessments of amyloid-PET images. An abnormal amyloid biomarker assessment is a key criterion to determine eligibility for anti-amyloid disease-modifying therapies, and amyloid-PET quantification can add further value by precisely monitoring amyloid clearance, and hence guiding patient management decisions. HIGHLIGHTS: Centiloid (CL) quantification robustly reflects of the amount of Aβ pathology. CL < 10/CL > 30 reflects Aβ-negativity/positivity thresholds with high certainty. CL quantification is a valuable adjunct to visual assessments of amyloid-PET. CL quantification can support trial design and treatment management. CL quantification could support the identification of early or emerging Aβ pathology.

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Referència

Collij LE, Bollack A, La Joie R, Shekari M, Bullich S, Roé-Vellvé N, Koglin N, Jovalekic A, Garciá DV, Drzezga A, Garibotto V, Stephens AW, Battle M, Buckley C, Barkhof F, Farrar G, Gispert JD; AMYPAD consortium. Centiloid recommendations for clinical context-of-use from the AMYPAD consortium. Alzheimers Dement. 2024 Nov 20. doi: 10.1002/alz.14336. Epub ahead of print. PMID: 39564918.