Binding characteristics of [ 18 F]PI-2620 distinguish the clinically predicted tau isoform in different tauopathies by PET

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Song, Mengmeng | Beyer, Leonie | Kaiser, Lena | Barthel, Henryk | van Eimeren, Thilo | Marek, Ken | Nitschmann, Alexander | Scheifele, Maximilian | Palleis, Carla | Respondek, Gesine | Kern, Maike | Biechele, Gloria | Hammes, Jochen | Bischof, Gèrard | Barbe, Michael | Onur, Özgür | Jessen, Frank | Saur, Dorothee | Schroeter, Matthias | Rumpf, Jost-Julian | Rullmann, Michael | Schildan, Andreas | Patt, Marianne | Neumaier, Bernd | Barret, Olivier | Madonia, Jennifer | Russell, David | Stephens, Andrew | Mueller, Andre | Roeber, Sigrun | Herms, Jochen | Bötzel, Kai | Danek, Adrian | Levin, Johannes | Classen, Joseph | Höglinger, Günter | Bartenstein, Peter | Villemagne, Victor | Drzezga, Alexander | Seibyl, John | Sabri, Osama | Boening, Guido | Ziegler, Sibylle | Brendel, Matthias

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International audience. The novel tau-PET tracer [ 18 F]PI-2620 detects the 3/4-repeat-(R)-tauopathy Alzheimer’s disease (AD) and the 4R-tauopathies corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP). We determined whether [ 18 F]PI-2620 binding characteristics deriving from non-invasive reference tissue modelling differentiate 3/4R- and 4R-tauopathies. Ten patients with a 3/4R tauopathy (AD continuum) and 29 patients with a 4R tauopathy (CBS, PSP) were evaluated. [ 18 F]PI-2620 PET scans were acquired 0-60 min p.i. and the distribution volume ratio (DVR) was calculated. [ 18 F]PI-2620-positive clusters (DVR ≥ 2.5 SD vs. 11 healthy controls) were evaluated by non-invasive kinetic modelling. R1 (delivery), k2 & k2a (efflux), DVR, 30-60 min standardized-uptake-value-ratios (SUVR 30-60 ) and the linear slope of post-perfusion phase SUVR (9-60 min p.i.) were compared between 3/4R- and 4R-tauopathies. Cortical clusters of 4R-tau cases indicated higher delivery (R1 SRTM : 0.92 ± 0.21 vs. 0.83 ± 0.10, p = 0.0007), higher efflux (k2 SRTM : 0.17/min ±0.21/min vs. 0.06/min ± 0.07/min, p < 0.0001), lower DVR (1.1 ± 0.1 vs. 1.4 ± 0.2, p < 0.0001), lower SUVR 30-60 (1.3 ± 0.2 vs. 1.8 ± 0.3, p < 0.0001) and flatter slopes of the post-perfusion phase (slope 9-60 : 0.006/min ± 0.007/min vs. 0.016/min ± 0.008/min, p < 0.0001) when compared to 3/4R-tau cases. [ 18 F]PI-2620 binding characteristics in cortical regions differentiate 3/4R- and 4R-tauopathies. Higher tracer clearance indicates less stable binding in 4R tauopathies when compared to 3/4R-tauopathies.

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