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@INPROCEEDINGS{Palleis:283042,
author = {Palleis, Carla and Franzmeier, Nicolai and Gnoerich,
Johannes and Jäck, Alexander and Bernhardt, Alexander M and
Katzdobler, Sabrina and Fietzek, Urban and Weidinger, Endy
and Frontzkowski, Lukas and Roemer-Cassiano, Sebastian and
Zwergal, Andreas and Barthel, Henryk and Sabri, Osama and
Levin, Johannes and Höglinger, Günter U and Brendel,
Matthias},
title = {{C}linical value of 18 {F}‐{PI}2620‐{PET} in the
diagnostic workup of patients with suspected {P}rogressive
{S}upranuclear {P}alsy},
journal = {Alzheimer's and dementia},
volume = {21},
number = {S2},
issn = {1552-5260},
reportid = {DZNE-2025-01449},
pages = {e102121},
year = {2025},
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.},
month = {Jul},
date = {2025-07-27},
organization = {Alzheimer’s Association
International Conference, Toronto
(Canada), 27 Jul 2025 - 31 Jul 2025},
keywords = {Humans / Supranuclear Palsy, Progressive: diagnostic
imaging / Supranuclear Palsy, Progressive: diagnosis /
Supranuclear Palsy, Progressive: metabolism / Male / Female
/ tau Proteins: metabolism / Biomarkers: metabolism /
Positron-Emission Tomography / Aged / Longitudinal Studies /
Prospective Studies / Middle Aged / Disease Progression /
tau Proteins (NLM Chemicals) / Biomarkers (NLM Chemicals)},
cin = {AG Haass / Clinical Research (Munich) / AG Levin / AG
Höglinger},
ddc = {610},
cid = {I:(DE-2719)1110007 / I:(DE-2719)1111015 /
I:(DE-2719)1111016 / I:(DE-2719)1110002},
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)1 / PUB:(DE-HGF)16},
doi = {10.1002/alz70856_102121},
url = {https://pub.dzne.de/record/283042},
}