MR-guided TOF-BSREM PET Reconstruction on PET/MRI: Improved Inter-Reader Reproducibility and Diagnostic Confidence in Amyloid-beta PET

Motivation: With the approval of disease-modifying therapies for Alzheimer's disease, accurate amyloid-beta PET assessment is crucial to determine their indicattions, requiring reproducibility and repeatability in visual and quantitative evaluations. Goal(s): To assess the inter-reader reproducibility and quantitative accuracy of amyloid-beta PET imaging using MR-guided TOF-BSREM (MRgTOF-BSREM) compared to TOF-OSEM. Approach: Amyloid-beta PET images from 22 patients were reconstructed with MRgTOF-BSREM and TOF-OSEM. Three readers visually assessed images, and quantitative measurements of Centiloid scale and SUVR were analyzed for agreement. Results: MRgTOF-BSREM showed improved inter-reader reproducibility and image quality confidence over TOF-OSEM, with high correlation in quantitative metrics, indicating potential for enhanced diagnostic reliability. Impact: MRgTOF-BSREM improves inter-reader reproducibility and diagnostic confidence in amyloid-beta PET imaging compared to conventional methods, supporting its potential to enhance treatment indication assessments for Alzheimer's disease-modifying therapies through more accurate visual and quantitative evaluations.