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Research ArticleBrain
Open Access

Visual-Statistical Interpretation of 18F-FDG-PET Images for Characteristic Alzheimer Patterns in a Multicenter Study: Inter-Rater Concordance and Relationship to Automated Quantitative Evaluation

T. Yamane, Y. Ikari, T. Nishio, K. Ishii, K. Ishii, T. Kato, K. Ito, D.H.S. Silverman, M. Senda, T. Asada, H. Arai, M. Sugishita, T. Iwatsubo and the J-ADNI Study Group
American Journal of Neuroradiology February 2014, 35 (2) 244-249; DOI: https://doi.org/10.3174/ajnr.A3665
T. Yamane
aFrom the Division of Molecular Imaging (T.Y., Y.I., T.N., M. Senda), Institute of Biomedical Research and Innovation, Kobe, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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Y. Ikari
aFrom the Division of Molecular Imaging (T.Y., Y.I., T.N., M. Senda), Institute of Biomedical Research and Innovation, Kobe, Japan
jResearch Association for Biotechnology (Y.I., T.N.), Tokyo, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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T. Nishio
aFrom the Division of Molecular Imaging (T.Y., Y.I., T.N., M. Senda), Institute of Biomedical Research and Innovation, Kobe, Japan
jResearch Association for Biotechnology (Y.I., T.N.), Tokyo, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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K. Ishii
bDepartment of Radiology (Kazunari Ishii), Kinki University Faculty of Medicine, Osakasayama, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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K. Ishii
cPositron Medical Center (Kenji Ishii), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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T. Kato
dDepartment of Brain Science and Molecular Imaging (T.K., K. Ito), National Center for Geriatrics and Gerontology, Obu, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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K. Ito
dDepartment of Brain Science and Molecular Imaging (T.K., K. Ito), National Center for Geriatrics and Gerontology, Obu, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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D.H.S. Silverman
eDavid Geffen School of Medicine (D.H.S.S.), University of California, Los Angeles, Los Angeles, California
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M. Senda
aFrom the Division of Molecular Imaging (T.Y., Y.I., T.N., M. Senda), Institute of Biomedical Research and Innovation, Kobe, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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T. Asada
fDepartment of Psychiatry (T.A.), University of Tsukuba, Tsukuba, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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H. Arai
gDepartment of Geriatrics and Gerontology (H.A.), Tohoku University, Sendai, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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M. Sugishita
hInstitute of Brain and Blood Vessels (M. Sugishita), Isezaki, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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T. Iwatsubo
iDepartment of Neuropathology and Neuroscience (T.I.), University of Tokyo, Tokyo, Japan
kJ-ADNI Core (T.Y., Y.I., T.N., Kazunari Ishii, Kenji Ishii, T.K., Kengo Ito, M.S., T.A., H.A., M.S., T.I.).
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    Fig 1.

    Breakdown of the 18F-FDG-PET cases into degree of match by 3 raters in a combined visual-statistical human classification into 7 (FDG-7) (A) or 2 (FDG-2) (B) categories. A perfect match by the 3 raters is observed for 62% of the cases for FDG-7 and 76% for FDG-2 in total. The AD group shows the highest concordance followed by the MCI and NC groups, in this order, both for FDG-7 and FDG-2.

  • Fig 2.
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    Fig 2.

    Boxplots of the FDG-PET score against the number of raters who interpreted the 18F-FDG-PET images as P1 (A) and N1 (B) based on the FDG-7 criteria. The FDG-PET score gradually increases as the number of P1 (AD pattern) interpretations increases (Spearman rank correlation coefficient: ρ = 0.59, P < .0001). On the other hand, FDG-PET score gradually decreases as the number of N1 (normal pattern) interpretations increases (ρ = −.64, P < .0001).

  • Fig 3.
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    Fig 3.

    Scatterplot of the FDG-PET score as contrasted with the combined visual-statistical interpretation determined by the consensus read of 18F-FDG-PET for each clinical group (A, NC; B, MCI; and C, AD). The horizontal line indicates the cutoff level of 0.67 derived by receiver operating characteristic analysis on P1 and N1 cases.

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American Journal of Neuroradiology: 35 (2)
American Journal of Neuroradiology
Vol. 35, Issue 2
1 Feb 2014
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Visual-Statistical Interpretation of 18F-FDG-PET Images for Characteristic Alzheimer Patterns in a Multicenter Study: Inter-Rater Concordance and Relationship to Automated Quantitative Evaluation
T. Yamane, Y. Ikari, T. Nishio, K. Ishii, K. Ishii, T. Kato, K. Ito, D.H.S. Silverman, M. Senda, T. Asada, H. Arai, M. Sugishita, T. Iwatsubo, the J-ADNI Study Group
American Journal of Neuroradiology Feb 2014, 35 (2) 244-249; DOI: 10.3174/ajnr.A3665

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Visual-Statistical Interpretation of 18F-FDG-PET Images for Characteristic Alzheimer Patterns in a Multicenter Study: Inter-Rater Concordance and Relationship to Automated Quantitative Evaluation
T. Yamane, Y. Ikari, T. Nishio, K. Ishii, K. Ishii, T. Kato, K. Ito, D.H.S. Silverman, M. Senda, T. Asada, H. Arai, M. Sugishita, T. Iwatsubo, the J-ADNI Study Group
American Journal of Neuroradiology Feb 2014, 35 (2) 244-249; DOI: 10.3174/ajnr.A3665
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