Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec 22.
doi: 10.1097/RLU.0000000000006254. Online ahead of print.

18F-FDG, 18F-FP-CIT, and 18F-Florzolotau PET Imaging in Progressive Supranuclear Palsy: Region-Specific Correlations Between Glucose Metabolism, Dopaminergic Function, and Tau Pathology

Menglin Liang  1 , Chenhao Jia  1 , Zhaoxia Huang  1 , Tianhao Zhang  2   3 , Qijun Li  1 , Meiqi Wu  1 , Tzu-Chen Yen  4 , Han Wang  5 , Ruixue Cui  1
Affiliations

18F-FDG, 18F-FP-CIT, and 18F-Florzolotau PET Imaging in Progressive Supranuclear Palsy: Region-Specific Correlations Between Glucose Metabolism, Dopaminergic Function, and Tau Pathology

Menglin Liang et al. Clin Nucl Med. .

Abstract

Purpose: Imaging protocols for progressive supranuclear palsy (PSP) are increasingly incorporating different PET modalities-including 18F-fluorodeoxyglucose (18F-FDG; cerebral glucose metabolism), 18F-FP-CIT (dopamine transporter [DAT] activity), and 18F-Florzolotau (tau pathology) PET-to improve diagnostic accuracy. In this cross-sectional study, we characterized tracer-specific imaging patterns and evaluated their interrelationships in patients with PSP to clarify the underlying pathophysiological mechanisms.

Materials and methods: Twenty-eight patients with clinically diagnosed PSP underwent 18F-FDG, 18F-FP-CIT, and 18F-Florzolotau PET imaging. Quantitative voxel-based and region-of-interest analyses were conducted. Standardized uptake value ratios (SUVRs) were calculated and compared with sex-matched controls (n=20 per PET modality).

Results: In patients with PSP compared with controls, 18F-FDG PET revealed significant glucose hypometabolism in frontal, parietal, cerebellar, and subcortical regions. 18F-FP-CIT PET demonstrated reduced DAT availability in the striatum and midbrain. Finally, 18F-Florzolotau PET showed elevated tau deposition in the thalamus, midbrain, pons, and precentral gyrus. An inverse correlation linked midbrain tau burden with local glucose metabolism (r=-0.39, P=0.04). Frontal hypometabolism correlated strongly with subcortical metabolic deficits (r=0.61, P<0.001). Only the left putamen showed a moderate negative association between DAT loss and tau accumulation (r=-0.42, P=0.03).

Conclusions: Patients with PSP exhibit metabolic deficits in cortical-subcortical networks, dopaminergic denervation in striatal-midbrain regions, and tau pathology localized to brainstem and thalamic areas. Tracer-specific SUVRs correlations revealed specific interplay among glucose hypometabolism, DAT deficiency, and tau accumulation.

Keywords: cerebral glucose metabolism; dopamine transporter; positron emission tomography; progressive supranuclear palsy; tau pathology.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest and sources of funding: This study was supported by the National High-Level Hospital Clinical Research Funding (grant number 2025-PUMCH-D-003), the National Natural Science Foundation of China (grant number 82402335 and 12205329), and Ye Ming Han Fund (2024) (grant number X21520603). T.-C.Y. is an employee and shareholder of APRINOIA Therapeutics Co., Ltd. (Suzhou, China). All other authors report no relevant financial or non-financial conflicts of interest.

References

    1. Boxer AL, Yu JT, Golbe LI, et al. Advances in progressive supranuclear palsy: new diagnostic criteria, biomarkers, and therapeutic approaches. Lancet Neurol. 2017;16:552–563.
    1. Jabbari E, Holland N, Chelban V, et al. Diagnosis across the spectrum of progressive supranuclear palsy and corticobasal syndrome. JAMA Neurol. 2020;77:377–387.
    1. Ali F, Clark H, Machulda M, et al. Patterns of brain volume and metabolism predict clinical features in the progressive supranuclear palsy spectrum. Brain Commun. 2024;6:fcae233.
    1. Lee I, Kim JS, Park JY, et al. Head-to-head comparison of (18) F-FP-CIT and (123) I-FP-CIT for dopamine transporter imaging in patients with Parkinson’s disease: a preliminary study. Synapse. 2018;72:e22032.
    1. Li L, Liu FT, Li M, et al. Clinical utility of (18) F-APN-1607 tau PET imaging in patients with progressive supranuclear palsy. Mov Disord. 2021;36:2314–2323.

LinkOut - more resources