Liu Feng-Tao, Lu Jia-Ying, Li Xin-Yi, Ge Jing-Jie, Sun Yi-Min, Yen Tzu-Chen, Jiao Fang-Yang, Chen Ming-Jia, Zhao Jun, Yao Rui-Xin, Tang Gan, Xu Hao, Lan Xiao-Li, Lu Jie, Cui Rui-Xue, Brendel Matthias, Shi Kuangyu, Guan Yi-Hui, Rominger Axel, Wang Jian, Zuo Chuan-Tao
Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, and State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China.
Department of Nuclear Medicine & PET Center, National Center for Neurological Disorders, and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Eur J Nucl Med Mol Imaging. 2025 Jan;52(2):586-598. doi: 10.1007/s00259-024-06923-3. Epub 2024 Oct 1.
The identification of tau accumulation within living brains holds significant potential in facilitating accurate diagnosis of progressive supranuclear palsy (PSP). While visual assessment is frequently employed, standardized methods for tau positron emission tomography (PET) specifically in PSP are absent. We aimed to develop a visual reading algorithm dedicated to the evaluation of [F]Florzolotau PET in PSP.
148 PSP and 30 healthy volunteers were divided into a development set (for the establishment of the reading rules; n = 89) and a testing set (for the validation of the reading rules; n = 89). For differential diagnosis, 55 α-synucleinopathies were additionally included into the testing set. The visual reading method was established by an experienced assessor (Reader 0) and was then validated by Reader 0 and two additional readers on regional and overall binary manners. A positive binding in both midbrain and globus pallidus/putamen regions was characterized as a PSP-like pattern, whereas any other pattern was classified as non-PSP-like.
Reader 1 (94.4%) and Reader 2 (93.8%) showed excellent agreement for the overall binary determination against Reader 0. The regional binary determinations of midbrain and globus pallidus/putamen showed excellent agreement among readers (kappa > 0.80). The overall binary evaluation demonstrated reproducibility of 86.1%, 94.4% and 77.8% for three readers. The visual reading algorithm showed high agreement with regional standardized uptake value ratios and clinical diagnoses.
Through the application of the suggested visual reading algorithm, [F]Florzorotau PET imaging demonstrated a robust performance for the imaging diagnosis of PSP.
识别活体脑内的tau蛋白积聚在促进进行性核上性麻痹（PSP）的准确诊断方面具有巨大潜力。虽然视觉评估经常被采用，但目前尚无专门针对PSP的tau正电子发射断层扫描（PET）标准化方法。我们旨在开发一种专门用于评估PSP中[F]Florzolotau PET的视觉解读算法。
将148例PSP患者和30名健康志愿者分为一个开发集（用于制定解读规则；n = 89）和一个测试集（用于验证解读规则；n = 89）。为进行鉴别诊断，另外55例α-突触核蛋白病患者被纳入测试集。视觉解读方法由一名经验丰富的评估者（读者0）建立，然后由读者0以及另外两名读者在区域和整体二元方式上进行验证。中脑和苍白球/壳核区域均出现阳性结合被定义为PSP样模式，而任何其他模式则被归类为非PSP样模式。
读者1（94.4%）和读者2（93.8%）在与读者0的整体二元判定上显示出极好的一致性。中脑和苍白球/壳核的区域二元判定在读者之间显示出极好的一致性（kappa＞0.80）。三位读者的整体二元评估显示可重复性分别为86.1%、94.4%和77.8%。视觉解读算法与区域标准化摄取值比率和临床诊断显示出高度一致性。
通过应用所建议的视觉解读算法，[F]Florzorotau PET成像在PSP的成像诊断中表现出强大的性能。
