Quantitation of PET spatial extent as a potential adjunct to visual interpretation of [18F]flortaucipir imaging: TAU-SPEX
Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE: Among visually Tau-PET-positive scans, large variation exists in the size of the visually tau-positive area. Here, we propose a metric quantifying the spatial extent of visual Tau-PET-positivity, termed "TAU-SPEX", and evaluate associations with visual read status, neurofibrillary tangle (NFT) pathology at autopsy, and cognition. METHODS: F]flortaucipir data from 1,645 participants (aged 71.9 ± 8.2 years, 50.3% females) from four cohorts were visually read as positive or negative. TAU-SPEX was calculated as the percentage of gray matter voxels with suprathreshold Tau-PET uptake (using a threshold identical to that used for visual reading) in a spatially unconstrained whole-brain mask. We additionally computed Tau-PET SUVr in a whole-brain and temporal meta-region. We tested the performance of TAU-SPEX for distinguishing visually tau-negative from tau-positive participants and for distinguishing participants with and without NFT Braak-V/VI pathology at autopsy (n = 18), and tested associations of TAU-SPEX with concurrent and longitudinal cognition. The performance of TAU-SPEX was compared to SUVr. RESULTS: TAU-SPEX demonstrated strong performance in distinguishing tau-negative from tau-positive participants (AUC: 0.97). Moreover, TAU-SPEX showed high accuracy, sensitivity, specificity, positive predictive value and negative predictive value (all > 0.90) for identifying tau-positive participants, and showed high sensitivity (87.5%) and specificity (100.0%) for identifying participants with NFT Braak-V/VI pathology. TAU-SPEX was moderately associated with concurrent (β=-0.36 [-0.29, -0.43], p < 0.001) and longitudinal (β=-0.19 [-0.15, -0.22], p < 0.001) cognition. Across analyses, TAU-SPEX generally outperformed SUVr. CONCLUSION: F]flortaucipir visual interpretation.
Authors: Emma M. Coomans, Bastiaan van Tol, Colin Groot, Ruben Smith, Sebastian Palmqvist, Erik Stomrud, Michael J. Pontecorvo, Sergey Shcherbinin, Ian Kennedy, Vikas Kotari, Wiesje M. van der Flier, Yolande A. L. Pijnenburg, Niklas Mattsson-Carlgren, Oskar Hansson, Elsmarieke van de Giessen, Rik Ossenkoppele
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,490
Awards: G1613806636, G2516983177, Novel biomarkers for improving diagnostics, prognostics, and treatments of Alzheimer’s disease, G4687921803, Prospective validation of high-performing blood biomarkers and digital cognitive tests in both specialist memory clinic and general primary care settings, G71844602
OpenAlex ID: W4411111809