petBrain: a new pipeline for amyloid, Tau tangles and neurodegeneration quantification using PET and MRI.

INTRODUCTION: Quantification of amyloid plaques (A), neurofibrillary tangles (T), and neurodegeneration (N) using PET and MRI is critical for Alzheimer's disease (AD) diagnosis and prognosis. Existing pipelines face limitations regarding processing time, tracer variability handling, and multimodal integration. METHODS: We developed petBrain, a novel end-to-end processing pipeline for amyloid-PET, tau-PET, and structural MRI. It leverages deep learning-based segmentation, standardized biomarker quantification (Centiloid, CenTauR, HAVAs), and simultaneous estimation of A, T, and N biomarkers. It is implemented in a web-based format, requiring no local computational infrastructure and software usage knowledge. RESULTS: petBrain provides reliable, rapid quantification with results comparable to existing pipelines for A and T, showing strong concordance with data processed in ADNI databases. The staging and quantification of A/T/N by petBrain demonstrated good agreements with CSF/plasma biomarkers, clinical status and cognitive performance. DISCUSSION: petBrain represents a powerful open platform for standardized AD biomarker analysis, facilitating clinical research applications.