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000283042 0247_ $$2doi$$a10.1002/alz70856_102121
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000283042 0247_ $$2ISSN$$a1552-5279
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000283042 041__ $$aEnglish
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000283042 1001_ $$0P:(DE-2719)9000852$$aPalleis, Carla$$b0$$eFirst author
000283042 1112_ $$aAlzheimer’s Association International Conference$$cToronto$$d2025-07-27 - 2025-07-31$$gAAIC 25$$wCanada
000283042 245__ $$aClinical value of 18 F‐PI2620‐PET in the diagnostic workup of patients with suspected Progressive Supranuclear Palsy
000283042 260__ $$c2025
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000283042 520__ $$aBackground: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.
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000283042 650_7 $$2NLM Chemicals$$atau Proteins
000283042 650_7 $$2NLM Chemicals$$aBiomarkers
000283042 650_2 $$2MeSH$$aHumans
000283042 650_2 $$2MeSH$$aSupranuclear Palsy, Progressive: diagnostic imaging
000283042 650_2 $$2MeSH$$aSupranuclear Palsy, Progressive: diagnosis
000283042 650_2 $$2MeSH$$aSupranuclear Palsy, Progressive: metabolism
000283042 650_2 $$2MeSH$$aMale
000283042 650_2 $$2MeSH$$aFemale
000283042 650_2 $$2MeSH$$atau Proteins: metabolism
000283042 650_2 $$2MeSH$$aBiomarkers: metabolism
000283042 650_2 $$2MeSH$$aPositron-Emission Tomography
000283042 650_2 $$2MeSH$$aAged
000283042 650_2 $$2MeSH$$aLongitudinal Studies
000283042 650_2 $$2MeSH$$aProspective Studies
000283042 650_2 $$2MeSH$$aMiddle Aged
000283042 650_2 $$2MeSH$$aDisease Progression
000283042 7001_ $$aFranzmeier, Nicolai$$b1
000283042 7001_ $$0P:(DE-2719)9001652$$aGnoerich, Johannes$$b2
000283042 7001_ $$0P:(DE-2719)9002626$$aJäck, Alexander$$b3
000283042 7001_ $$0P:(DE-2719)9002620$$aBernhardt, Alexander M$$b4
000283042 7001_ $$0P:(DE-2719)9001160$$aKatzdobler, Sabrina$$b5
000283042 7001_ $$0P:(DE-2719)9001214$$aFietzek, Urban$$b6
000283042 7001_ $$0P:(DE-2719)9000882$$aWeidinger, Endy$$b7
000283042 7001_ $$aFrontzkowski, Lukas$$b8
000283042 7001_ $$aRoemer-Cassiano, Sebastian$$b9
000283042 7001_ $$aZwergal, Andreas$$b10
000283042 7001_ $$aBarthel, Henryk$$b11
000283042 7001_ $$0P:(DE-2719)2814810$$aSabri, Osama$$b12
000283042 7001_ $$0P:(DE-2719)2811659$$aLevin, Johannes$$b13
000283042 7001_ $$0P:(DE-2719)2811373$$aHöglinger, Günter U$$b14
000283042 7001_ $$0P:(DE-2719)9001539$$aBrendel, Matthias$$b15$$eLast author
000283042 773__ $$0PERI:(DE-600)2201940-6$$a10.1002/alz70856_102121$$gVol. 21, no. S2, p. e102121$$nS2$$pe102121$$tAlzheimer's and dementia$$v21$$x1552-5260$$y2025
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