Skip to content
DraconiticResearch
Search Sources API
179,152 studies31 sourcesUpdated 20 min ago
Peer-reviewedCC BY 4.0Journal of Nuclear Medicine

Concordance Between [18F]Flortaucipir PET Visual Reads and CenTauR-Based Quantification

  • Stamatia Karagianni1,2
  • Alexis Moscoso3
  • Sheelakumari Raghavan4
  • Martijn van Essen5,6
  • Ismini Mainta7
  • Valle Camacho8
  • Omar Rodríguez-Fonseca9
  • Jesús Silva-Rodríguez10
  • Andrés Perissinotti11,12
  • Yuna Gu13
  • Jihwan Yun14
  • Nicolai Franzmeier2,15,16
9 more authors
  • Michel J. Grothe10
  • Sang Won Seo13,17,18
  • Giovanni B. Frisoni19,20
  • Valentina Garibotto7,21
  • Christopher G. Schwarz4
  • Ronald C. Petersen22
  • Clifford R. Jack4
  • Prashanthi Vemuri4
  • Michael Schöll1,2,23
23 affiliations
  1. 1Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
  2. 2Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  3. 3Nuclear Medicine Department and Molecular Imaging Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
  4. 4Department of Radiology, Mayo Clinic, Rochester, Minnesota
  5. 5Department of Clinical Physiology/Nuclear Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
  6. 6Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
  7. 7Division of Nuclear Medicine, Geneva University Hospitals, Geneva, Switzerland
  8. 8Department of Nuclear Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
  9. 9Nuclear Medicine Department, Lucus Augusti University Hospital, Lugo, Spain
  10. 10Reina Sofía Foundation Alzheimer’s Centre, CIEN Foundation, ISCIII, Madrid, Spain
  11. 11Nuclear Medicine Department, Hospital Clínic Barcelona–IDIBAPS, Barcelona, Spain
  12. 12Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine, ISCIII, Barcelona, Spain
  13. 13Samsung Alzheimer Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
  14. 14Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
  15. 15Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
  16. 16Munich Cluster for Systems Neurology, Munich, Germany
  17. 17Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
  18. 18Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
  19. 19Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
  20. 20Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
  21. 21Faculty of Medicine, University of Geneva and Center for Biomedical Imaging, Switzerland
  22. 22Department of Neurology, Mayo Clinic, Rochester, Minnesota; and
  23. 23Department of Neuropsychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
Read full textDOICite

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.

Related

  1. When Is Amyloid Really Cleared? Substantial Discordance Between Centiloid Quantification and Visual Reads of Amyloid PET after Amyloid-Targeting Therapy
    R. La Joie, M. Lin, Y. Wang +16
    medRxivPreprintCC BY-NC-NDFull textMedical imaging & radiologymedRxiv
  2. Detection of tau spatial extent using MK6240 and flortaucipir PET
    G. Povala, B. Bellaver, L. Amaral +21
    medRxivPreprintAll rights reservedFull textNeurologymedRxiv
  3. Tau PET Braak staging across the Alzheimer Disease continuum using Flortaucipir and MK6240
    A. Rocha, C. Soares, M. Scoop Medeiros +30
    medRxivPreprintAll rights reservedFull textNeurologymedRxiv
  4. Tau positron emission tomography harmonization using the CenTauR approach: General conversion equations, relevant cut-points, and external validation.
    Alexis Moscoso Rial, Antoine Leuzy, Lars Lau Raket +62
    Alzheimer's & dementia : the journal of the Alzheimer's AssociationPeer-reviewedCC BYFull textPsychiatry & mental healthEurope PMCPMC
  5. Head-to-Head Comparison of Flortaucipir and MK6240 tau-PET to Detect Subtle Objective Cognitive Impairment in Clinically Unimpaired Individuals
    A. C. Macedo, E. Aumont, L. Trudel +33
    medRxivPreprintCC BY-NCFull textNeurologymedRxiv

Cite

BibTeXRIS
BibTeX
@article{karagianni2026concordance,
  title = {{Concordance Between [18F]Flortaucipir PET Visual Reads and CenTauR-Based Quantification}},
  author = {Stamatia Karagianni and Alexis Moscoso and Sheelakumari Raghavan and Martijn van Essen and Ismini Mainta and Valle Camacho and Omar Rodríguez-Fonseca and Jesús Silva-Rodríguez and Andrés Perissinotti and Yuna Gu and Jihwan Yun and Nicolai Franzmeier and Michel J. Grothe and Sang Won Seo and Giovanni B. Frisoni and Valentina Garibotto and Christopher G. Schwarz and Ronald C. Petersen and Clifford R. Jack and Prashanthi Vemuri and Michael Schöll},
  journal = {Journal of Nuclear Medicine},
  year = {2026},
  month = nov,
  doi = {10.2967/jnumed.126.272722},
  url = {https://doi.org/10.2967/jnumed.126.272722},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Concordance Between [18F]Flortaucipir PET Visual Reads and CenTauR-Based Quantification
AU  - Stamatia Karagianni
AU  - Alexis Moscoso
AU  - Sheelakumari Raghavan
AU  - Martijn van Essen
AU  - Ismini Mainta
AU  - Valle Camacho
AU  - Omar Rodríguez-Fonseca
AU  - Jesús Silva-Rodríguez
AU  - Andrés Perissinotti
AU  - Yuna Gu
AU  - Jihwan Yun
AU  - Nicolai Franzmeier
AU  - Michel J. Grothe
AU  - Sang Won Seo
AU  - Giovanni B. Frisoni
AU  - Valentina Garibotto
AU  - Christopher G. Schwarz
AU  - Ronald C. Petersen
AU  - Clifford R. Jack
AU  - Prashanthi Vemuri
AU  - Michael Schöll
PY  - 2026
DA  - 2026/11/03
JO  - Journal of Nuclear Medicine
DO  - 10.2967/jnumed.126.272722
UR  - https://doi.org/10.2967/jnumed.126.272722
AB  - 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.
SN  - 0161-5505
SN  - 1535-5667
ER  -