Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical features

Abstract This study developed machine learning models to predict Aβ positivity in Alzheimer’s disease by integrating early-phase 18F-Florbetaben PET and clinical data to improve diagnostic accuracy. Furthermore, the study explored machine learning models to predict cognitive status from early-phase...

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Main Authors: Dong Hyeok Choi, So Hyun Ahn, Yujin Chung, Jin Sung Kim, Jee Hyang Jeong, Hai-Jeon Yoon
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-00743-7
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author Dong Hyeok Choi
So Hyun Ahn
Yujin Chung
Jin Sung Kim
Jee Hyang Jeong
Hai-Jeon Yoon
author_facet Dong Hyeok Choi
So Hyun Ahn
Yujin Chung
Jin Sung Kim
Jee Hyang Jeong
Hai-Jeon Yoon
author_sort Dong Hyeok Choi
collection DOAJ
description Abstract This study developed machine learning models to predict Aβ positivity in Alzheimer’s disease by integrating early-phase 18F-Florbetaben PET and clinical data to improve diagnostic accuracy. Furthermore, the study explored machine learning models to predict cognitive status from early-phase PET, maximizing the clinical utility of dual-phase imaging protocols. 176 subjects who completed dual-phase 18F-FBB PET scanning including 38 with normal cognition, 94 with mild cognitive impairment, and 44 with dementia were enrolled. Aβ status was determined from delayed-phase 18F-FBB PET scans (90–110 min post-injection). To develop a machine learning model for predicting Aβ positivity, we utilized early-phase PET and clinical features. From early-phase 18F-FBB PET scans (0–10 min post-injection), we extracted brain region-specific standardized uptake value ratios (SUVR) as imaging features. Various classifiers, including Random Forest, Gradient Boosting, and XGBoost, were trained and evaluated using accuracy, ROC AUC, recall, and F1 scores. Feature importance was assessed to identify key predictors, and the importance of features that most significantly influenced each model’s results was calculated. The early-phase PET alone showed moderate performance (80.56% accuracy with Random Forest), with hippocampus (importance: 0.086), isthmus of cingulate (0.051), and entorhinal (0.038) SUVR values as top predictors. The combined PET and clinical data model achieved the highest accuracy (88.89%) using Gradient Boosting, with key predictors including APOE genotype (importance: 0.2485), Medial Orbitofrontal SUVR (0.0996), and hippocampal SUVR (0.0663). In predicting cognitive status using early-phase PET, most classifiers achieved high accuracy (> 80%) and F1 scores (0.82–0.90), with Decision Tree showing the highest accuracy of 83.33%. Machine learning models combining PET and clinical data demonstrated superior predictive accuracy for Aβ positivity prediction, while early-phase PET alone showed robust performance in predicting cognitive status, highlighting the synergistic potential of multimodal data and versatile utility of early-phase PET imaging.
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spelling doaj-art-94eedfb69d4b4b2e99f31eea356d65402025-08-20T03:38:11ZengNature PortfolioScientific Reports2045-23222025-07-0115111210.1038/s41598-025-00743-7Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical featuresDong Hyeok Choi0So Hyun Ahn1Yujin Chung2Jin Sung Kim3Jee Hyang Jeong4Hai-Jeon Yoon5Department of Medicine, Yonsei University College of MedicineEwha Medical Research Institute, School of Medicine, Ewha Womans UniversityDepartment of Medicine, Warren Alpert Medical School, Brown UniversityDepartment of Medicine, Yonsei University College of MedicineDepartment of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of MedicineDepartment of Nuclear Medicine, Ewha Womans University College of MedicineAbstract This study developed machine learning models to predict Aβ positivity in Alzheimer’s disease by integrating early-phase 18F-Florbetaben PET and clinical data to improve diagnostic accuracy. Furthermore, the study explored machine learning models to predict cognitive status from early-phase PET, maximizing the clinical utility of dual-phase imaging protocols. 176 subjects who completed dual-phase 18F-FBB PET scanning including 38 with normal cognition, 94 with mild cognitive impairment, and 44 with dementia were enrolled. Aβ status was determined from delayed-phase 18F-FBB PET scans (90–110 min post-injection). To develop a machine learning model for predicting Aβ positivity, we utilized early-phase PET and clinical features. From early-phase 18F-FBB PET scans (0–10 min post-injection), we extracted brain region-specific standardized uptake value ratios (SUVR) as imaging features. Various classifiers, including Random Forest, Gradient Boosting, and XGBoost, were trained and evaluated using accuracy, ROC AUC, recall, and F1 scores. Feature importance was assessed to identify key predictors, and the importance of features that most significantly influenced each model’s results was calculated. The early-phase PET alone showed moderate performance (80.56% accuracy with Random Forest), with hippocampus (importance: 0.086), isthmus of cingulate (0.051), and entorhinal (0.038) SUVR values as top predictors. The combined PET and clinical data model achieved the highest accuracy (88.89%) using Gradient Boosting, with key predictors including APOE genotype (importance: 0.2485), Medial Orbitofrontal SUVR (0.0996), and hippocampal SUVR (0.0663). In predicting cognitive status using early-phase PET, most classifiers achieved high accuracy (> 80%) and F1 scores (0.82–0.90), with Decision Tree showing the highest accuracy of 83.33%. Machine learning models combining PET and clinical data demonstrated superior predictive accuracy for Aβ positivity prediction, while early-phase PET alone showed robust performance in predicting cognitive status, highlighting the synergistic potential of multimodal data and versatile utility of early-phase PET imaging.https://doi.org/10.1038/s41598-025-00743-718F-FlorbetabenPositron emission tomographyEarly-phaseAmyloid-βCognitive status
spellingShingle Dong Hyeok Choi
So Hyun Ahn
Yujin Chung
Jin Sung Kim
Jee Hyang Jeong
Hai-Jeon Yoon
Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical features
Scientific Reports
18F-Florbetaben
Positron emission tomography
Early-phase
Amyloid-β
Cognitive status
title Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical features
title_full Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical features
title_fullStr Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical features
title_full_unstemmed Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical features
title_short Machine learning model for predicting Amyloid-β positivity and cognitive status using early-phase 18F-Florbetaben PET and clinical features
title_sort machine learning model for predicting amyloid β positivity and cognitive status using early phase 18f florbetaben pet and clinical features
topic 18F-Florbetaben
Positron emission tomography
Early-phase
Amyloid-β
Cognitive status
url https://doi.org/10.1038/s41598-025-00743-7
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