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Research ArticleNeurology

One-Stop Shop: 18F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases

Jochen Hammes, Gérard N. Bischof, Karl P. Bohn, Özgür Onur, Anja Schneider, Klaus Fliessbach, Merle C Hönig, Frank Jessen, Bernd Neumaier, Alexander Drzezga and Thilo van Eimeren
Journal of Nuclear Medicine February 2021, 62 (2) 240-246; DOI: https://doi.org/10.2967/jnumed.120.244061
Jochen Hammes
1Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
2Radiologische Allianz, Hamburg, Germany
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Gérard N. Bischof
1Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
3Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
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Karl P. Bohn
1Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
4Department of Nuclear Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland
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Özgür Onur
5Department of Neurology, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
6Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
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Anja Schneider
7German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany
8Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, University of Bonn, Bonn, Germany
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Klaus Fliessbach
7German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany
8Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, University of Bonn, Bonn, Germany
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Merle C Hönig
1Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
9Molecular Organization of the Brain (INM-2), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
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Frank Jessen
7German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany
10Department of Psychiatry, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
11Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany; and
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Bernd Neumaier
12Nuclear Chemistry (INM-5), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany, and Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
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Alexander Drzezga
1Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
7German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany
9Molecular Organization of the Brain (INM-2), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
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Thilo van Eimeren
1Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
5Department of Neurology, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
7German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany
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Abstract

Tau protein aggregations are a hallmark of amyloid-associated Alzheimer disease and some forms of non–amyloid-associated frontotemporal lobar degeneration. In recent years, several tracers for in vivo tau imaging have been under evaluation. This study investigated the ability of 18F-flortaucipir PET not only to assess tau positivity but also to differentiate between amyloid-positive and -negative forms of neurodegeneration on the basis of different 18F-flortaucipir PET signatures. Methods: The 18F-flortaucipir PET data of 35 patients with amyloid-positive neurodegeneration, 19 patients with amyloid-negative neurodegeneration, and 17 healthy controls were included in a data-driven scaled subprofile model (SSM)/principal-component analysis (PCA) identifying spatial covariance patterns. SSM/PCA pattern expression strengths were tested for their ability to predict amyloid status in a receiver-operating-characteristic analysis and validated with a leave-one-out approach. Results: Pattern expression strengths predicted amyloid status with a sensitivity of 0.94 and a specificity of 0.83. A support vector machine classification based on pattern expression strengths in 2 different SSM/PCA components yielded a prediction accuracy of 98%. Anatomically, prediction performance was driven by parietooccipital gray matter in amyloid-positive patients versus predominant white matter binding in amyloid-negative patients. Conclusion: SSM/PCA-derived binding patterns of 18F-flortaucipir differentiate between amyloid-positive and -negative neurodegenerative diseases with high accuracy. 18F-flortaucipir PET alone may convey additional information equivalent to that from amyloid PET. Together with a perfusion-weighted early-phase acquisition (18F-FDG PET–equivalent), a single scan potentially contains comprehensive information on amyloid (A), tau (T), and neurodegeneration (N) status as required by recent biomarker classification algorithms (A/T/N).

  • flortaucipir
  • AV-1451
  • T807
  • tau PET
  • SSM/PCA

Footnotes

  • Published online Jul. 3, 2020.

  • © 2021 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 62 (2)
Journal of Nuclear Medicine
Vol. 62, Issue 2
February 1, 2021
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One-Stop Shop: 18F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases
Jochen Hammes, Gérard N. Bischof, Karl P. Bohn, Özgür Onur, Anja Schneider, Klaus Fliessbach, Merle C Hönig, Frank Jessen, Bernd Neumaier, Alexander Drzezga, Thilo van Eimeren
Journal of Nuclear Medicine Feb 2021, 62 (2) 240-246; DOI: 10.2967/jnumed.120.244061

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One-Stop Shop: 18F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases
Jochen Hammes, Gérard N. Bischof, Karl P. Bohn, Özgür Onur, Anja Schneider, Klaus Fliessbach, Merle C Hönig, Frank Jessen, Bernd Neumaier, Alexander Drzezga, Thilo van Eimeren
Journal of Nuclear Medicine Feb 2021, 62 (2) 240-246; DOI: 10.2967/jnumed.120.244061
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Keywords

  • Flortaucipir
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