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Multitracer model for staging cortical amyloid deposition using PET imaging
Collij LE, Heeman F, Salvadó G, Ingala S, Altomare D, de Wilde A, Konijnenberg E, van Buchem M et al.. Neurology, 2020-07-16
Topic: Amyloid, tau and blood-test diagnosis
Objective To develop and evaluate a model for staging cortical amyloid deposition using PET with high generalizability. Methods Three thousand twenty-seven individuals (1,763 cognitively unimpaired [CU], 658 impaired, 467 with Alzheimer disease [AD] dementia, 111 with non-AD dementia, and 28 with missing diagnosis) from 6 cohorts (European Medical Information Framework for AD, Alzheimer's and Family, Alzheimer's Biomarkers in Daily Practice, Amsterdam Dementia Cohort, Open Access Series of Imaging Studies [OASIS]-3, Alzheimer's Disease Neuroimaging Initiative [ADNI]) who underwent amyloid PET were retrospectively included; 1,049 individuals had follow-up scans. With application of dataset-specific cutoffs to global standard uptake value ratio (SUVr) values from 27 regions, single-tracer and pooled multitracer regional rankings were constructed from the frequency of abnormality across 400 CU individuals (100 per tracer). The pooled multitracer ranking was used to create a staging model consisting of 4 clusters of regions because it displayed a high and consistent correlation with each single-tracer ranking. Relationships between amyloid stage, clinical variables, and longitudinal cognitive decline were investigated. Results SUVr abnormality was most frequently observed in cingulate, followed by orbitofrontal, precuneal, and insular cortices and then the associative, temporal, and occipital regions. Abnormal amyloid levels based on binary global SUVr classification were observed in 1.0%, 5.5%, 17.9%, 90.0%, and 100.0% of individuals in stage 0 to 4, respectively. Baseline stage predicted decline in Mini-Mental State Examination (MMSE) score (ADNI: n = 867, F = 67.37, p F = 9.12, p stage1 2.00, HR stage2 3.53, HR stage3 4.55, HR stage4 9.91, p stage4 4.80, p Conclusion The pooled multitracer staging model successfully classified the level of amyloid burden in >3,000 individuals across cohorts and radiotracers and detects preglobal amyloid burden and distinct risk profiles of cognitive decline within globally amyloid-positive individuals.
Key findings
- Results SUVr abnormality was most frequently observed in cingulate, followed by orbitofrontal, precuneal, and insular cortices and then the associative, temporal, and occipital regions.
Why it matters
This study developed a model for staging cortical amyloid deposition using PET, finding that amyloid abnormality appeared first in the cingulate and then spread to other regions. It is about staging and measurement, not about treating, curing, or preventing Alzheimer disease.
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Study details
- Study designlongitudinal study
- Participants867
- Effect size1.0%; 5.5%; 17.9%
- Evidence strengthModerate
How this study scored 68/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 867 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 101 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.6 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 4 / 6 | Cited 8.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 7 other studies in this library |
| Still being cited | 2 / 4 | Cited 47 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Natàlia Vilor‐Tejedor: h-index 31 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32675080) |
| Free to read | 2 / 2 | Free to read |
| Total | 68 / 100 | — |
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Read the original
- DOI: 10.1212/wnl.0000000000010256
- PubMed: 32675080
- Original source →
- Free full text: PubMed Central →
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Collij, L. E., Heeman, F., Salvadó, G., Ingala, S., Altomare, D., de Wilde, A., et al. (2020). Multitracer model for staging cortical amyloid deposition using PET imaging. Neurology. https://doi.org/10.1212/wnl.0000000000010256
Vancouver
Collij LE, Heeman F, Salvadó G, Ingala S, Altomare D, de Wilde A, et al. Multitracer model for staging cortical amyloid deposition using PET imaging. Neurology. 2020. doi:10.1212/wnl.0000000000010256. PMID: 32675080.
BibTeX
@article{collij2020-32675080,
author = {Collij, L. E. and Heeman, F. and Salvadó, G. and Ingala, S. and Altomare, D. and de Wilde, A. and Konijnenberg, E. and van Buchem, M. and others},
title = {{Multitracer model for staging cortical amyloid deposition using PET imaging}},
journal = {Neurology},
year = {2020},
doi = {10.1212/wnl.0000000000010256},
pmid = {32675080},
url = {https://doi.org/10.1212/wnl.0000000000010256}
}
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