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@ARTICLE{Bauer:275967,
      author       = {Bauer, Theresa and Brendel, Matthias and Zaganjori, Mirlind
                      and Bernhardt, Alexander M and Jäck, Alexander and
                      Stöcklein, Sophia and Scheifele, Maximilian and Levin,
                      Johannes and van Eimeren, Thilo and Drzezga, Alexander and
                      Sabri, Osama and Barthel, Henryk and Perneczky, Robert and
                      Höglinger, Günter and Franzmeier, Nicolai and Gnörich,
                      Johannes},
      collaboration = {Tauopathies, German Imaging Initiative for},
      title        = {{P}ragmatic algorithm for visual assessment of 4-{R}epeat
                      tauopathies in [18{F}]{PI}-2620 {PET} {S}cans.},
      journal      = {NeuroImage},
      volume       = {306},
      issn         = {1053-8119},
      address      = {Orlando, Fla.},
      publisher    = {Academic Press},
      reportid     = {DZNE-2025-00163},
      pages        = {121001},
      year         = {2025},
      abstract     = {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.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).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. $91\%).Visual$ 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.},
      keywords     = {Reading algorithm (Other) / Tau-PET (Other) / Tauopathies
                      (Other) / Visual read (Other)},
      cin          = {AG Haass / Clinical Research (Munich) / AG Levin / AG
                      Boecker / AG Dichgans},
      ddc          = {610},
      cid          = {I:(DE-2719)1110007 / I:(DE-2719)1111015 /
                      I:(DE-2719)1111016 / I:(DE-2719)1011202 /
                      I:(DE-2719)5000022},
      pnm          = {352 - Disease Mechanisms (POF4-352) / 353 - Clinical and
                      Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-352 / G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39798829},
      doi          = {10.1016/j.neuroimage.2025.121001},
      url          = {https://pub.dzne.de/record/275967},
}