Evaluation of Web-based Training to Educate Physicians in the Methods of Interpreting Florbetapir-PET Scans

Evaluation of Web-based Training to Educate Physicians in the Methods of Interpreting Florbetapir-PET Scans

Evaluation of Web-based Training to Educate Physicians in the Methods of Interpreting Florbetapir-PET Scans

This study will investigate the performance of physician readers trained to read florbetapir-PET scans using electronic media training.

Avid has previously developed a florbetapir-PET scan binary read methodology and training program, which was successfully applied in studies 18F-AV-45-A08(NCT01565369), 18F-AV-45-A09(NCT01565382) and 18F-AV-45-A16(NCT01447719). In these previous studies, training was conducted in-person. Study 18F-AV-45-PT01 will evaluate an automated version of this training program suitable for web-based distribution. Nuclear medicine physicians will complete the automated training program then read the florbetapir-PET images from 151 subjects with repeat readings of 33 randomly selected images. Readers will rate each case as either positive for significant tracer accumulation in cortical gray matter or negative for significant tracer accumulation in cortical gray matter. The inter-rater reliability, sensitivity and specificity of the readers will be evaluated. The primary image set for determination of inter-reader agreement is comprised of images from 119 subjects from two previous clinical studies (A07[NCT00857415]/A16[NCT01447719] and A05[NCT00702143]). This included all 59 subjects who came to autopsy in Study A07(NCT00857415) and it's follow-up study, A16(NCT01447719), and a set of 60 cases randomly selected from Study A05(NCT00702143) subjects, including 20 cognitively-normal controls, 20 with mild cognitive impairment) MCI, 20 with AD. Subsequently, the protocol was amended to include all remaining A05(NCT00702143) MCI patients that were not used in the training program (n=32); 13 of these 32 scans presented for repeat reading (to increase the number of A05 MCI cases with repeated reads to 20). This increased the number of unique cases in the validation dataset to 151 scans with 33 scans repeated yielding a total of 184 scans reviewed by the readers.

No study drug will be administered in this study - scans previously acquired in in Study A05(NCT00702143) and A07(NCT00857415) will be read

Measure of agreement among five readers using a binary read method (amyloid positive/negative) calculated using Fleiss' kappa. All scans were read in a blinded fashion without access to clinical information.

Sensitivity of Florbetapir-PET to Detect Moderate to Frequent Beta-amyloid Neuritic Plaques (Probable/Definite Alzheimer's Disease)

Specificity of Florbetapir-PET to Detect no or Sparse Beta-amyloid Neuritic Plaques (Probable/Definite Alzheimer's Disease)

Median sensitivity and specificity for 5 independent readers to detect moderate to frequent amyloid plaques (per CERAD criteria).

Eligibility for subjects scans to be used in this study is determined by subject's eligibility/enrollment in Study A05 (NCT00702143) or A07 (NCT00857415). Alzheimer's disease (AD) group key eligibility criteria (from Study A05[NCT00702143]): Male or female at least 50 years of age Have probable AD per National Institute of Neurological and Communication Disorders and Stroke (NINCDS) criteria Mini mental state exam (MMSE) score between 10 and 24 inclusive Mild cognitive impairment group key eligibility criteria (from Study A05[NCT00702143): Male or female at least 50 years of age Complaints of memory or cognitive decline corroborated by an informant Clinical dementia rating of 0.5 No obvious cause for cognitive impairment (eg, head trauma or stroke) Cognitive impairment onset within the past year MMSE score greater than 24 Cognitively normal volunteer group key eligibility criteria (from Study A05[NCT00702143]): Male or female at least 50 years of age MMSE score greater than or equal to 29 and cognitively normal by informant report and psychometric test battery at screening Autopsy cohort key eligibility criteria (from Study A07[NCT00857415]): Male or female 18 years or older Projected life expectancy of less than 6 months Consent to brain donation