A Harmonized Visual Reading Framework for Tau PET Staging in Alzheimer Disease
Abstract
Key Points Question Can a harmonized visual reading framework enable reliable, tracer-agnostic staging of tau positron emission tomography (PET) pathology for clinical use? Findings In this multicenter cross-sectional study of 681 participants scanned with multiple tau PET radiotracers, a 5-class harmonized visual reading framework demonstrated high interrater and intertracer agreement and identified more early-stage tau pathology than the regulatory-approved approach. Tau burden classes were associated with progressively worse cognition, greater amyloid-β burden, and higher plasma phosphorylated tau 217 (p-tau217) concentrations. Meaning A harmonized visual reading framework may enable consistent detection and staging of Alzheimer disease pathology, improve comparability across tracers, and support biomarker-informed clinical decision-making.