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ABSTRACT Objective Dopaminergic imaging is a key biomarker for both the investigation of biology of Parkinson’s Disease and related synucleinopathies and the evaluation of potential therapies in clinical trials. This work presents a harmonized approach for quantifying dopaminergic molecular imaging tracers, such as [¹²³I]ioflupane (DaTscan™) SPECT and [¹[F]AV133 PET, which assess dopaminergic neuronal loss. The proposed method aims to standardize regional outcome measures using a unified scale called Centamines. Methods The Centamines framework comprises three analysis levels. Level 1 defines the Centamine scale based on healthy subject data from [¹²³I]ioflupane SPECT (n=224). Level 2 uses Head-to-Head data between Tracer X and [¹²³I]ioflupane SPECT to map Tracer X onto the Centamine scale. Level 3 maps additional tracers using prior mappings. A Level 2 analysis was performed using [¹²³I]ioflupane SPECT and [¹[F]AV133 PET data (n=68) to convert [¹[F]AV133 PET into Centamines. Results Level 1 successfully established the Centamine scale using healthy [¹²³I]ioflupane SPECT scans. Level 2 revealed moderate-strong linear correlations (R² = 0.44–0.78) between [¹²³I]ioflupane SPECT and [¹[F]AV133 PET across five brain regions. Mapped Centamine values showed minimal differences between tracers, ranging from 1.5% (Post-Commissural Putamen) to 3% (Caudate). Interpretation The Centamine scale holds promise for the harmonized quantification of dopaminergic neuronal imaging markers. The Centamine strategy would enable and accelerate clinical trials in Parkinson’s Disease utilizing dopaminergic imaging outcomes.
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