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@ARTICLE{Kling:280249,
author = {Kling, Agnes and Kusche-Palenga, Julia and Palleis, Carla
and Jäck, Alexander and Bernhardt, Alexander M and
Frontzkowski, Lukas and Römer, Sebastian and Slemann, Luna
and Zaganjori, Mirlind and Scheifele, Maximilian and Paeger,
Lars and Bischof, Gérard N and van Eimeren, Thilo and
Drzezga, Alexander and Sabri, Osama and Rullmann, Michael
and Barthel, Henryk and Levin, Johannes and Herms, Jochen
and Franzmeier, Nicolai and Höglinger, Günter and Roeber,
Sigrun and Brendel, Matthias and Gnoerich, Johannes},
title = {{E}xploring the origins of frequent tau-{PET} signal in
vermal and adjacent regions.},
journal = {European journal of nuclear medicine and molecular imaging},
volume = {52},
number = {10},
issn = {1619-7070},
address = {Heidelberg [u.a.]},
publisher = {Springer-Verl.},
reportid = {DZNE-2025-00927},
pages = {3519 - 3533},
year = {2025},
abstract = {Off-target binding remains a significant challenge in
tau-PET neuroimaging. While off-targets including monoamine
oxidase enzymes and neuromelanin-containing cells have been
identified, recent studies indicated a relevant binding of
novel tau tracers to melanin-containing structures. To date,
little is known about the effect of melanocytes in the
meninges on tracer signals in brain PET data. Thus, we aimed
to identify the target structure causal for the frequently
observed [18F]PI-2620 PET signal in the vermis and adjacent
cerebellar regions.274 participants underwent dynamic
[18F]PI-2620 tau-PET: 3/4R-tauopathies (n = 85),
4R-tauopathies (n = 147), tau-negative disease controls (n =
24), and healthy controls (n = 18). Standardized uptake
value ratio (SUVR) and kinetic parameters including the
distribution volume ratio (DVR), tracer clearance (k2) and
relative perfusion (R1), were compared among the cohorts and
sexes using the Automated Anatomical Labelling (AAL) atlas.
Age and p-Tau levels in cerebrospinal fluid (CSF) were
assessed for their relationship with vermal tau-PET signal.
Furthermore, we combined autoradiographic and histochemical
experiments on post-mortem brain tissue of deceased patients
(n = 9).Male participants revealed higher mean vermal
[18F]PI-2620 DVR (0.95 ± 0.13; vs. females 0.88 ± 0.10, p
< 0.0001). Sex-related differences were most pronounced in
the 3/4R-tauopathy cohort (p < 0.0001). Mean SUVRVer/Cbl, k2
and correlation analyses of kinetic parameters did not
differ among groups. Histological assessments revealed
co-localization of leptomeningeal pigmented cells with
strong autoradiography signal spots within the vermal
fissures. Tau-related autoradiography signals, age or p-Tau
levels did not correlate significantly with tau-PET signals.
Iron deposits did not cause relevant autoradiography signals
in the vermis.Leptomeningeal melanocytes are the primary
target structure for [18F]PI-2620 PET binding in anterior
vermis, whereas iron and tau deposits do not contribute
significantly.},
keywords = {Neuroimaging: methods / tau Proteins: analysis / tau
Proteins: metabolism / Positron-Emission Tomography: methods
/ Fluorine Radioisotopes: administration $\&$ dosage /
Fluorine Radioisotopes: pharmacology / Cerebellar Vermis:
diagnostic imaging / Cerebellar Vermis: metabolism /
Cerebellar Vermis: pathology / Tauopathies: diagnostic
imaging / Tauopathies: metabolism / Tauopathies: pathology /
Humans / Male / Female / Middle Aged / Aged / Aged, 80 and
over / Case-Control Studies / Pyridines / Cerebellum (Other)
/ Melanocytes (Other) / Meninges (Other) / Off-target
binding (Other) / Tau-PET (Other) / Vermis (Other) / tau
Proteins (NLM Chemicals) / ((18)F)PI-2620 (NLM Chemicals) /
Fluorine Radioisotopes (NLM Chemicals) / Pyridines (NLM
Chemicals)},
cin = {AG Haass / Clinical Research (Munich) / AG Herms / AG
Boecker / AG Levin},
ddc = {610},
cid = {I:(DE-2719)1110007 / I:(DE-2719)1111015 /
I:(DE-2719)1110001 / I:(DE-2719)1011202 /
I:(DE-2719)1111016},
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:40100387},
pmc = {pmc:PMC12316827},
doi = {10.1007/s00259-025-07199-x},
url = {https://pub.dzne.de/record/280249},
}