{ "abstract": "Tau PET imaging with [18F]flortaucipir allows for the visualization and mapping of aggregated tau deposits, a key neuropathologic feature of Alzheimer disease (AD). A visual interpretation method for [18F]flortaucipir was approved by the Food and Drug Administration and European Medicines Agency and has been implemented for a standardized, clinically usable definition of tau PET positivity. The CenTauRz method, on the other hand, offers the possibility to harmonize the definition of tau PET positivity across different radiotracers using quantitative metrics, but its concordance with clinically relevant [18F]flortaucipir visual reads remains unclear. Methods: A convenience sample of 3991 participants, including cognitively unimpaired (CU) and cognitively impaired (CI) individuals (i.e., those with mild cognitive impairment or AD dementia), underwent [18F]flortaucipir PET imaging. Each [18F]flortaucipir scan was assessed by 3 trained readers using the approved visual interpretation method and quantified using the CenTauRz quantification pipeline in different regions of interest (ROIs). Concordance between positive visual reads and CenTauRz-defined positivity (i.e., >2 on the CenTauRz scale) was assessed using Cohen κ. Receiver-operating-characteristic (ROC) analysis evaluated the discriminative power of continuous CenTauRz values in distinguishing between negative and positive visual reads. Generalized additive models examined clinical progression on the basis of visual and CenTauRz-based assessments of tau PET positivity. Results: Concordance between visual reads and CenTauRz-based assessments of tau PET positivity was moderate, particularly in CU individuals (κ = 0.23–0.55 for CU participants, κ = 0.57–0.82 for CI participants, depending on the ROI). ROC analysis revealed that the agreement remained moderate, independent of the CenTauRz cut point used (area under the ROC curve, 0.72–0.87 vs. 0.87–0.97 for CU and CI individuals, respectively). Among discordant cases, participants with visually positive/CenTauRz-negative tau PET scans were more frequently amyloid-positive and exhibited faster clinical progression compared with visually negative/CenTauRz-positive individuals. Conclusion: Our findings highlight the relatively limited agreement between the visual assessment of [18F]flortaucipir PET images and CenTauRz-based quantification, particularly in CU individuals. Participants with visually positive/CenTauRz-negative tau PET scans showed a high frequency of amyloid positivity and faster clinical progression, suggesting that visual reads are more sensitive to heterogeneous, clinically relevant tau accumulation patterns not captured by ROI-based methods. These findings underscore the need for new quantification approaches to better capture the complex patterns of tau deposition, important for early AD detection and monitoring.", "abstract_shown": true, "affiliations": [ "Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden", "Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden", "Nuclear Medicine Department and Molecular Imaging Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain", "Department of Radiology, Mayo Clinic, Rochester, Minnesota", "Department of Clinical Physiology/Nuclear Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden", "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden", "Division of Nuclear Medicine, Geneva University Hospitals, Geneva, Switzerland", "Department of Nuclear Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain", "Nuclear Medicine Department, Lucus Augusti University Hospital, Lugo, Spain", "Reina Sofía Foundation Alzheimer’s Centre, CIEN Foundation, ISCIII, Madrid, Spain", "Nuclear Medicine Department, Hospital Clínic Barcelona–IDIBAPS, Barcelona, Spain", "Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine, ISCIII, Barcelona, Spain", "Samsung Alzheimer Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea", "Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea", "Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany", "Munich Cluster for Systems Neurology, Munich, Germany", "Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea", "Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea", "Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland", "Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland", "Faculty of Medicine, University of Geneva and Center for Biomedical Imaging, Switzerland", "Department of Neurology, Mayo Clinic, Rochester, Minnesota; and", "Department of Neuropsychiatry, Sahlgrenska University Hospital, Mölndal, Sweden" ], "article_type": "research article", "arxiv": null, "author_total": 21, "authors": [ { "affs": [ 0, 1 ], "name": "Stamatia Karagianni" }, { "affs": [ 2 ], "name": "Alexis Moscoso" }, { "affs": [ 3 ], "name": "Sheelakumari Raghavan" }, { "affs": [ 4, 5 ], "name": "Martijn van Essen" }, { "affs": [ 6 ], "name": "Ismini Mainta" }, { "affs": [ 7 ], "name": "Valle Camacho" }, { "affs": [ 8 ], "name": "Omar Rodríguez-Fonseca" }, { "affs": [ 9 ], "name": "Jesús Silva-Rodríguez" }, { "affs": [ 10, 11 ], "name": "Andrés Perissinotti" }, { "affs": [ 12 ], "name": "Yuna Gu" }, { "affs": [ 13 ], "name": "Jihwan Yun" }, { "affs": [ 1, 14, 15 ], "name": "Nicolai Franzmeier" }, { "affs": [ 9 ], "name": "Michel J. Grothe" }, { "affs": [ 12, 16, 17 ], "name": "Sang Won Seo" }, { "affs": [ 18, 19 ], "name": "Giovanni B. Frisoni" }, { "affs": [ 6, 20 ], "name": "Valentina Garibotto" }, { "affs": [ 3 ], "name": "Christopher G. Schwarz" }, { "affs": [ 21 ], "name": "Ronald C. Petersen" }, { "affs": [ 3 ], "name": "Clifford R. Jack" }, { "affs": [ 3 ], "name": "Prashanthi Vemuri" }, { "affs": [ 0, 1, 22 ], "name": "Michael Schöll" } ], "bibtex": "https://research.draconitic.com/paper/bag1k82pp9evg.bib", "cited_by": 0, "doi": "10.2967/jnumed.126.272722", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13724712/", "id": "bag1k82pp9evg", "issns": [ "0161-5505", "1535-5667" ], "landing_url": "https://doi.org/10.2967/jnumed.126.272722", "language": "en", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Clinical Investigation" ], [ "openalex", "2738|Dementia and Cognitive Impairment Research" ] ], "openalex": "W7196977390", "pdf_url": null, "pmcid": "PMC13724712", "pmid": "42562606", "published": "2026-11-03", "publisher": "Society of Nuclear Medicine and Molecular Imaging", "ris": "https://research.draconitic.com/paper/bag1k82pp9evg.ris", "sources": [ { "first_seen": "2026-11-04T12:23:14Z", "native_id": "PMC13724712", "source": "pmc", "url": "https://doi.org/10.2967/jnumed.126.272722" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2738|Dementia and Cognitive Impairment Research", "subfield": "psychiatry" } ], "title": "Concordance Between [18F]Flortaucipir PET Visual Reads and CenTauR-Based Quantification", "title_text": "Concordance Between [18F]Flortaucipir PET Visual Reads and CenTauR-Based Quantification", "type": "peer-reviewed", "updated_at": "2026-11-06T12:21:07Z", "url": "https://research.draconitic.com/paper/bag1k82pp9evg", "venue": "Journal of Nuclear Medicine", "versions": [] }