A first-in-class PET imaging approach can accurately detect biomarkers for chronic traumatic encephalopathy (CTE), a severe neurodegenerative disease associated with repeated head impacts. This imaging biomarker could potentially be used to diagnose patients while they are still alive, rather than waiting until after death, and could play an important role in supporting clinical trials to develop CTE treatments. This research was presented at the 2026 Annual Meeting of the Society for Nuclear Medicine and Molecular Imaging.
CTE is common in contact sports athletes, military veterans, victims of interpersonal or intimate partner violence, and even people who have experienced a traumatic brain injury. People with suspected CTE often experience mental health effects such as cognitive decline, mood symptoms, impulsivity, and dementia. Currently, CTE can only be conclusively diagnosed by postmortem neuropathological examination.
Postmortem, CTE is confirmed by the presence of tau plaques in the brain. However, existing tau PET tracers were primarily developed for Alzheimer’s disease and may not adequately detect the unique tau pathology seen in CTE. ”
Dr. Isabelle Boileau, Senior Scientist and Deputy Director, Brain Health Imaging Center, Head of the Addiction Imaging Research Group, Toronto Addiction and Mental Health Center
In this study, researchers evaluated the ability of a new tau PET radiotracer to recognize tau plaques in patients with suspected CTE. Three retired collision sports athletes and seven healthy controls underwent dynamic brain PET testing with 18F-OXD-2314. Tau distribution patterns were analyzed and specific regions of interest were evaluated. Additional studies were also conducted to evaluate the binding of 3H-OXD-2314 in postmortem CTE tissues.
Compared to healthy controls, images of individuals with suspected CTE revealed increased uptake of 18F-OXD-2314 in the gray matter junction and white matter. Additionally, 3H-OXD-2314 signals were observed in all postmortem CTE cases examined, providing initial biological confirmation that the tracer binds to tau lesions in human CTE tissue.
“If validated, 18F-OXD-2314 could help provide the first accurate antemortem diagnostic biomarker for CTE,” Boileau said. “This study also establishes a clinical role for PET in traumatic brain injury and sports- and military-related neurodegeneration, and may lead to the development of next-generation tau radiopharmaceuticals optimized for non-Alzheimer’s tauopathies, including CTE.”
He continued, “Although this radiopharmaceutical is in early clinical studies, our data in both patients with suspected CTE and patients with other non-Alzheimer’s tauopathies are very encouraging. Pending further research, PET imaging for CTE could be available to patients as early as the next two years.”
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Society of Nuclear Medicine and Molecular Imaging
