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When Is Amyloid Really Cleared? Substantial Discordance Between Centiloid Quantitation and Visual Reads of Amyloid PET after Amyloid-Targeting Therapy
La Joie R, Lin M, Wang Y, Soleimani-Meigooni DN, Ellingson T, Nguyen H, Blazhenets G, Fonseca CS et al.. medRxiv, 2026-10-06
Topic: Plasma and spinal-fluid biomarkers
: Treated patients were 74±7 years old; 57% were female, 59% were apolipoprotein E ε4 carriers, and 78% had mild cognitive impairment (22% mild dementia). Centiloid agreement between pipelines was equally high pre– and post-ATT (both ICCs=0.90). Among paired scans (mean treatment duration, 16.7±4.6 months), clearance estimates were similar across pipelines and greater with donanemab (n=15 patients; between –62 and –60 Centiloids/year depending on the pipeline) than lecanemab (n=26; –38 to –36 Centiloids/year; all P<0.005). Among 54 post-ATT scans, between 44% and 57% were <11 Centiloids depending on pipeline, with 20 (37%) meeting this criterion across all 3 pipelines. In contrast, only 11%–19% were visually negative across readers, with 4 (7%) unanimously read as negative. Of the 20 post-ATT scans <11 Centiloids across all pipelines, 13 (65%) were considered positive by all readers, commonly with residual occipital binding. : Centiloid quantitation was robust across pipelines before and after ATT initiation, yielding clearance rates consistent with clinical trials. However, quantitative and visual assessments were markedly discordant after ATT, with an unusually high proportion of scans <11 Centiloids remaining visually positive, warranting cautious interpretation of post-ATT Centiloid values. Larger studies should assess the clinical relevance of these findings and further develop robust approaches to establish full TRAC.
Key findings
- : Treated patients were 74±7 years old; 57% were female, 59% were apolipoprotein E ε4 carriers, and 78% had mild cognitive impairment (22% mild dementia).
- Centiloid agreement between pipelines was equally high pre– and post-ATT (both ICCs=0.90).
- Among paired scans (mean treatment duration, 16.7±4.6 months), clearance estimates were similar across pipelines and greater with donanemab (n=15 patients; between –62 and –60 Centiloids/year depending on the pipeline) than lecanemab (n=26; –38 to –36 Centiloids/year; all P<0.005).
- Among 54 post-ATT scans, between 44% and 57% were <11 Centiloids depending on pipeline, with 20 (37%) meeting this criterion across all 3 pipelines.
- In contrast, only 11%–19% were visually negative across readers, with 4 (7%) unanimously read as negative.
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Study details
- Participants15
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 27 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 17 of the 62 points we could judge it on, which is 27 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 15 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 17 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 17 of the 62 points we could judge it on is 27 out of 100. |
| Total | 27 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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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
La Joie, R., Lin, M., Wang, Y., Soleimani-Meigooni, D. N., Ellingson, T., Nguyen, H., et al. (2026). When Is Amyloid Really Cleared? Substantial Discordance Between Centiloid Quantitation and Visual Reads of Amyloid PET after Amyloid-Targeting Therapy. medRxiv. https://doi.org/10.64898/2026.10.03.26364642
Vancouver
La Joie R, Lin M, Wang Y, Soleimani-Meigooni DN, Ellingson T, Nguyen H, et al. When Is Amyloid Really Cleared? Substantial Discordance Between Centiloid Quantitation and Visual Reads of Amyloid PET after Amyloid-Targeting Therapy. medRxiv. 2026. doi:10.64898/2026.10.03.26364642.
BibTeX
@article{lajoie2026-fc03ab7d,
author = {La Joie, R. and Lin, M. and Wang, Y. and Soleimani-Meigooni, D. N. and Ellingson, T. and Nguyen, H. and Blazhenets, G. and Fonseca, C. S. and others},
title = {{When Is Amyloid Really Cleared? Substantial Discordance Between Centiloid Quantitation and Visual Reads of Amyloid PET after Amyloid-Targeting Therapy}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.10.03.26364642},
url = {https://doi.org/10.64898/2026.10.03.26364642}
}
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