Objective Dopaminergic imaging is a key biomarker for both the investigation of the 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 123 Iioflupane (dopamine transporter scan DaTscan) single photon emission computed tomography (SPECT) and 18 FAV133 positron emission tomography (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 3 analysis levels. Level 1 defines the Centamine scale based on healthy subject data from 123 Iioflupane SPECT (n = 224). Level 2 uses head‐to‐head data between Tracer X and 123 Iioflupane SPECT to map Tracer X onto the Centamine scale. Level 3 maps additional tracers using prior mappings. A level 2 analysis was performed using 123 Iioflupane SPECT and 18 FAV133 PET data (n = 68) to convert 18 FAV133 PET into Centamines. Results Level 1 successfully established the Centamine scale using healthy 123 Iioflupane SPECT scans. Level 2 revealed moderate‐strong linear correlations ( R 2 = 0.51–0.83) between 123 Iioflupane SPECT and 18 FAV133 PET across 5 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 using dopaminergic imaging outcomes. ANN NEUROL 2026
Fan et al. (Tue,) studied this question.