Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans
Aim: Standardized evaluation of [18F]PI-2620 tau-PET scans in 4R-tauopathies represents an unmet need in clinical practice. This study aims to investigate the effectiveness of visual evaluation of [18F]PI-2620 images for diagnosing 4R-tauopathies and to develop a straight-forward reading algorithm t...
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Elsevier
2025-02-01
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| Series: | NeuroImage |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1053811925000011 |
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| author | Theresa Bauer Matthias Brendel Mirlind Zaganjori Alexander M. Bernhardt Alexander Jäck Sophia Stöcklein Maximilian Scheifele Johannes Levin Thilo van Eimeren Alexander Drzezga Osama Sabri Henryk Barthel Robert Perneczky Günter Höglinger Nicolai Franzmeier Johannes Gnörich |
| author_facet | Theresa Bauer Matthias Brendel Mirlind Zaganjori Alexander M. Bernhardt Alexander Jäck Sophia Stöcklein Maximilian Scheifele Johannes Levin Thilo van Eimeren Alexander Drzezga Osama Sabri Henryk Barthel Robert Perneczky Günter Höglinger Nicolai Franzmeier Johannes Gnörich |
| author_sort | Theresa Bauer |
| collection | DOAJ |
| description | Aim: Standardized evaluation of [18F]PI-2620 tau-PET scans in 4R-tauopathies represents an unmet need in clinical practice. This study aims to investigate the effectiveness of visual evaluation of [18F]PI-2620 images for diagnosing 4R-tauopathies and to develop a straight-forward reading algorithm to improve objectivity and data reproducibility. Methods: A total of 83 individuals with [18F]PI-2620 PET scans were included. Participants were classified as probable 4R-tauopathies (n = 29), Alzheimer's disease (AD) (n = 20), α-synucleinopathies (n = 15), and healthy controls (n = 19) based on clinical criteria. Visual assessment of tau-PET scans (choice: 4R-tauopathy, AD-tauopathy, no-tauopathy) was conducted using either 20–40-minute or 40–60-minute intervals, with raw (common) and cerebellar grey matter scaled standardized reading settings (intensity-scaled). Two readers evaluated scans independently and blinded, with a third reader providing consensus in case of discrepant primary evaluation. A regional analysis was performed using the cortex, basal ganglia, midbrain, and dentate nucleus. Sensitivity, specificity, and interrater agreement were calculated for all settings and compared against the visual reads of parametric images (0–60-minutes, distribution volume ratios, DVR). Results: Patients with 4R-tauopathies in contrast to non-4R-tauopathies were detected at higher sensitivity in the 20–40-minute frame (common: 79%, scaled: 76%) compared to the 40–60-minute frame (common: 55%, scaled: 62%), albeit with reduced specificity in the common setting (20–40-min: 78%, 40–60-min: 95%), which was ameliorated in the intensity-scaled setting (20–40-min: 91%, 40–60-min: 96%). Combined assessment of multiple brain regions did not significantly improve diagnostic sensitivity, compared to assessing the basal ganglia alone (76% each). Evaluation of intensity-scaled parametric images resulted in higher sensitivity compared to intensity-scaled static scans (86% vs. 76%) at similar specificity (89% vs. 91%). Conclusion: Visual reading of [18F]PI-2620 tau-PET scans demonstrated reliable detection of 4R-tauopathies, particularly when standardized processing methods and early imaging windows were employed. Parametric images should be preferred for visual assessment of 4R-tauopathies. |
| format | Article |
| id | doaj-art-8c9eda37e0e64306b4321fd5638845f9 |
| institution | Kabale University |
| issn | 1095-9572 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
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| series | NeuroImage |
| spelling | doaj-art-8c9eda37e0e64306b4321fd5638845f92025-01-23T05:26:21ZengElsevierNeuroImage1095-95722025-02-01306121001Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET ScansTheresa Bauer0Matthias Brendel1Mirlind Zaganjori2Alexander M. Bernhardt3Alexander Jäck4Sophia Stöcklein5Maximilian Scheifele6Johannes Levin7Thilo van Eimeren8Alexander Drzezga9Osama Sabri10Henryk Barthel11Robert Perneczky12Günter Höglinger13Nicolai Franzmeier14Johannes Gnörich15Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, GermanyDepartment of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, GermanyDepartment of Nuclear Medicine, University Hospital, LMU Munich, Munich, GermanyGerman Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, University Hospital, LMU Munich, Munich, GermanyGerman Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, University Hospital, LMU Munich, Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Munich, GermanyDepartment of Nuclear Medicine, University Hospital, LMU Munich, Munich, GermanyGerman Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, University Hospital, LMU Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, GermanyDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, GermanyDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany; Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, GermanyUniversity Hospital Leipzig, Department of Nuclear Medicine, Leipzig, GermanyUniversity Hospital Leipzig, Department of Nuclear Medicine, Leipzig, GermanyGerman Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK; Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UKGerman Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, University Hospital, LMU Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, GermanyMunich Cluster for Systems Neurology (SyNergy), Munich, Germany; Institute for Stroke and Dementia Research, LMU Munich, Munich, Germany; University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Mölndal and Gothenburg, SwedenDepartment of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Correspondence author at Marchioninistrasse 15, 81377, Munich, GermanyAim: Standardized evaluation of [18F]PI-2620 tau-PET scans in 4R-tauopathies represents an unmet need in clinical practice. This study aims to investigate the effectiveness of visual evaluation of [18F]PI-2620 images for diagnosing 4R-tauopathies and to develop a straight-forward reading algorithm to improve objectivity and data reproducibility. Methods: A total of 83 individuals with [18F]PI-2620 PET scans were included. Participants were classified as probable 4R-tauopathies (n = 29), Alzheimer's disease (AD) (n = 20), α-synucleinopathies (n = 15), and healthy controls (n = 19) based on clinical criteria. Visual assessment of tau-PET scans (choice: 4R-tauopathy, AD-tauopathy, no-tauopathy) was conducted using either 20–40-minute or 40–60-minute intervals, with raw (common) and cerebellar grey matter scaled standardized reading settings (intensity-scaled). Two readers evaluated scans independently and blinded, with a third reader providing consensus in case of discrepant primary evaluation. A regional analysis was performed using the cortex, basal ganglia, midbrain, and dentate nucleus. Sensitivity, specificity, and interrater agreement were calculated for all settings and compared against the visual reads of parametric images (0–60-minutes, distribution volume ratios, DVR). Results: Patients with 4R-tauopathies in contrast to non-4R-tauopathies were detected at higher sensitivity in the 20–40-minute frame (common: 79%, scaled: 76%) compared to the 40–60-minute frame (common: 55%, scaled: 62%), albeit with reduced specificity in the common setting (20–40-min: 78%, 40–60-min: 95%), which was ameliorated in the intensity-scaled setting (20–40-min: 91%, 40–60-min: 96%). Combined assessment of multiple brain regions did not significantly improve diagnostic sensitivity, compared to assessing the basal ganglia alone (76% each). Evaluation of intensity-scaled parametric images resulted in higher sensitivity compared to intensity-scaled static scans (86% vs. 76%) at similar specificity (89% vs. 91%). Conclusion: Visual reading of [18F]PI-2620 tau-PET scans demonstrated reliable detection of 4R-tauopathies, particularly when standardized processing methods and early imaging windows were employed. Parametric images should be preferred for visual assessment of 4R-tauopathies.http://www.sciencedirect.com/science/article/pii/S1053811925000011Visual readTauopathiesTau-PETReading algorithm |
| spellingShingle | Theresa Bauer Matthias Brendel Mirlind Zaganjori Alexander M. Bernhardt Alexander Jäck Sophia Stöcklein Maximilian Scheifele Johannes Levin Thilo van Eimeren Alexander Drzezga Osama Sabri Henryk Barthel Robert Perneczky Günter Höglinger Nicolai Franzmeier Johannes Gnörich Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans NeuroImage Visual read Tauopathies Tau-PET Reading algorithm |
| title | Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans |
| title_full | Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans |
| title_fullStr | Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans |
| title_full_unstemmed | Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans |
| title_short | Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans |
| title_sort | pragmatic algorithm for visual assessment of 4 repeat tauopathies in 18f pi 2620 pet scans |
| topic | Visual read Tauopathies Tau-PET Reading algorithm |
| url | http://www.sciencedirect.com/science/article/pii/S1053811925000011 |
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