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@ARTICLE{Doering:1041319,
author = {Doering, Elena and Hoenig, Merle C. and Giehl, Kathrin and
Dzialas, Verena and Andrassy, Grégory and Bader, Abdelmajid
and Bauer, Andreas and Elmenhorst, David and Ermert,
Johannes and Frensch, Silke and Jäger, Elena and Jessen,
Frank and Krapf, Philipp and Kroll, Tina and Lerche,
Christoph and Lothmann, Julia and Matusch, Andreas and
Neumaier, Bernd and Onur, Oezguer A. and Ramirez, Alfredo
and Richter, Nils and Sand, Frederik and Tellmann, Lutz and
Theis, Hendrik and Zeyen, Philip and van Eimeren, Thilo and
Drzezga, Alexander and Bischof, Gerard Nisal},
title = {“{F}ill {S}tates”: {PET}-derived {M}arkers of the
{S}patial {E}xtent of {A}lzheimer {D}isease {P}athology},
journal = {Radiology},
volume = {314},
number = {3},
issn = {0033-8419},
address = {Oak Brook, Ill.},
publisher = {Soc.},
reportid = {FZJ-2025-02218},
pages = {e241482},
year = {2025},
note = {Deutsche Forschungsgemeinschaft [DFG] research grant
“Brain network dependent propagation of tau-pathology in
Alzheimer disease” DR 445/9-1 [AD]). Some co-authors
received funding from the DFG (project ID 431549029-SFB
1451). Datacollection and sharing for this project was
funded by the Alzheimer’s Disease Neuroimaging Initiative
(ADNI) (National Institutes of Health grant no. U01
AG024904) and U.S. Department of Defense ADNI (award no.
W81XWH-12-2-0012).},
abstract = {Background: Alzheimer disease (AD) progression can be
monitored by tracking intensity changes in PET standardized
uptake value (SUV) ratiosof amyloid, tau, and
neurodegeneration. The spatial extent (“fill state”) of
these three hallmark pathologic abnormalities may serve as
criticalpathophysiologic information, pending further
investigation.Purpose: To examine the clinical utility and
increase the accessibility of PET-derived fill
states.Materials and Methods: This secondary analysis of two
prospective studies used data from two independent cohorts:
the Alzheimer’s DiseaseNeuroimaging Initiative (ADNI) and
the Tau Propagation over Time study (T-POT). Each cohort
comprised amyloid-negative cognitively normalindividuals
(controls) and patients with subjective cognitive decline,
mild cognitive impairment, or probable-AD dementia. Fill
states of amyloid, tau,and neurodegeneration were computed
as the percentages of significantly abnormal voxels relative
to controls across PET scans. Fill states and SUVratios were
compared across stages (Kruskal-Wallis H test, area under
the receiver operating characteristic curve analysis) and
tested for associationwith the severity of cognitive
impairment (Spearman correlation, multivariate regression
analysis). Additionally, a convolutional neural network(CNN)
was developed to estimate fill states from patients’ PET
scans without requiring controls.Results: The ADNI cohort
included 324 individuals (mean age, 72 years ± 6.8 [SD];
173 $[53\%]$ female), and the T-POT cohort comprised
99individuals (mean age, 66 years ± 8.7; 63 $[64\%]$
female). Higher fill states were associated with higher
stages of cognitive impairment (P < .001),and tau and
neurodegeneration fill states showed higher diagnostic
performance for cognitive impairment compared with SUV ratio
(P < .05) acrosscohorts. Similarly, all fill states were
negatively correlated with cognitive performance (P < .001)
and uniquely characterized the degree of cognitiveimpairment
even after adjustment for SUV ratio (P < .05). The CNN
estimated amyloid and tau accurately, but not
neurodegeneration fill states.Conclusion: Fill states
provided reliable markers of AD progression, potentially
improving early detection, staging, and monitoring of AD in
clinicalpractice and trials beyond SUV ratio.},
cin = {INM-5 / INM-2 / INM-3 / INM-4},
ddc = {610},
cid = {I:(DE-Juel1)INM-5-20090406 / I:(DE-Juel1)INM-2-20090406 /
I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406},
pnm = {5253 - Neuroimaging (POF4-525)},
pid = {G:(DE-HGF)POF4-5253},
typ = {PUB:(DE-HGF)16},
pubmed = {40131110},
UT = {WOS:001464548700015},
doi = {10.1148/radiol.241482},
url = {https://juser.fz-juelich.de/record/1041319},
}