guest ::
| Home > Publications Database > Clinical value of 18 F‐PI2620‐PET in the diagnostic workup of patients with suspected Progressive Supranuclear Palsy |
| Home > Publications Database > Clinical value of 18 F‐PI2620‐PET in the diagnostic workup of patients with suspected Progressive Supranuclear Palsy |
| Abstract/Journal Article | DZNE-2025-01449 |
; ; ; ; ; ; ; ; ; ; ; ; ; ; ;
2025
This record in other databases:
Please use a persistent id in citations: doi:10.1002/alz70856_102121
Abstract: Background:Progressive Supranuclear Palsy (PSP) is a rapidly progressing 4-repeat tauopathy, presenting with clinically heterogeneous phenotypes. Currently, diagnoses are based solely on clinical criteria but reliable diagnostic classification remains particularly challenging at early stages. 18F-PI-2620 tau-PET is an evolving neuroimaging biomarker to capture 4-repeat tau (4RT) deposits in vivo with clear diagnostic potential in research settings. To determine the added clinical value of 18F-PI-2620 tau-PET in the diagnostic workup of PSP, we evaluated whether 18F-PI-2620-assessed 4RT positivity (i.e. using the basal ganglia as a target readout) predicts subsequent increases of diagnostic certainty for PSP, indicative of 4RT pathology driving clinical progression.Method:We collected monocentric longitudinal data at the LMU Hospital in Munich, from a non-randomized prospective cohort study between October 2018 and December 2024. Data collection included pre-PET visits with routine clinical classification following the MDS criteria. In addition, we performed 18F-PI-2620 tau-PET with dichotomous visual read assessments of 4RT pathology by an expert reader and collected clinical follow-up data or autopsy information.Results:342 patients with a pre-PET differential diagnosis of PSP were referred to 18F-PI-2620 tau-PET in clinical routine. Of those, 200 patients (61.5% male, mean±sd age 69.2±8.3 years) had a post-PET clinical follow-up between 12-24 months (mean±sd 17.1±4.2 months). 137 patients (68.5%) were rated 4RT-positive at baseline (Figure 1). The distribution of certainty of PSP diagnosis at baseline and at follow-up is displayed in Figure 2 (A&B: all PSP phenotypes; C&D: PSP-Richardson Syndrome [RS]; E&F: variant PSP subtypes). Change to a non-PSP diagnosis at follow-up occurred in 23.5%, identified by a negative baseline tau-PET in 95.5%. In contrast, 79% of tau-PET-positive patients with suggestive PSP progressed to a higher diagnostic certainty, 3% had histopathological confirmation of PSP diagnosis, 13% remained suggestive PSP, and 5% received a non-PSP diagnosis at follow-up.Conclusion:18F-PI-2620 tau-PET can successfully identify patients that progress along expected 4RT clinical spectra. This supports 18F-PI-2620 tau-PET as a 4RT biomarker, with the potential to facilitate early biomarker-based diagnosis when clinical criteria may still lack sensitivity and specificity. This development can be transformative for clinical decision making, pre-symptomatic identification of PSP and stratifying patients for disease modifying clinical trials.
Keyword(s): Humans (MeSH) ; Supranuclear Palsy, Progressive: diagnostic imaging (MeSH) ; Supranuclear Palsy, Progressive: diagnosis (MeSH) ; Supranuclear Palsy, Progressive: metabolism (MeSH) ; Male (MeSH) ; Female (MeSH) ; tau Proteins: metabolism (MeSH) ; Biomarkers: metabolism (MeSH) ; Positron-Emission Tomography (MeSH) ; Aged (MeSH) ; Longitudinal Studies (MeSH) ; Prospective Studies (MeSH) ; Middle Aged (MeSH) ; Disease Progression (MeSH) ; tau Proteins ; Biomarkers
; 
; 
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Wiley ; Essential Science Indicators ; IF >= 10 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
PDF
PDF (PDFA)