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You have full access to this open access article. From the trinary visual interpretation of the PiB PET images, 55 subjects were negative, 8 were equivocal, and 70 were positive. Negative interpretation was most frequent in the CN group The baseline SUVRs were 1. Subjects in the early stage of the AD continuum could be identified with an equivocal scan, because they showed intermediate quantitative amyloid PET, CSF measurements, and the amyloid accumulation over time.

Amyloid accumulation is predictive of a high probability of AD and is thought to begin before the appearance of clinical symptoms [ 1 ]. Amyloid positron emission tomography PET imaging using 11 C-Pittsburgh compound B PiB has enabled visual and quantitative evaluation of cortical amyloid deposition in vivo [ 2 , 3 ]. Time-course changes of amyloid deposition have been investigated using longitudinal semiquantitative values such as the standardized uptake value ratio SUVR of amyloid PET data.

Groups with high accumulation and low accumulation of amyloid PET, which were divided according to cutoff values obtained by various methods, have demonstrated increasing and non-increasing deposition of amyloid, respectively [ 4 , 5 , 6 , 7 , 8 ]. Visual inspection may detect deposition of amyloid plaques earlier than semiquantitative methods [ 9 ].

However, there has been no research that stratified amyloid accumulation by visual interpretation in longitudinal analyses. In recent years, research interest has moved to detection of the earliest accumulation of amyloid and how it changes over time, as well as how it relates to neurodegeneration and the decline in cognitive function, since accurate understanding of the relationship between clinical status and the extent of progression of amyloid pathology is necessary to develop amyloid-targeted treatment plans.