Classification of tau status with machine learning models in amyloid-positive cohorts
Abstract: Although tau positron emission tomography (PET) imaging is effective for staging tau pathology, it is limited clinically by cost and availability. Machine learning models based on magnetic resonance imaging (MRI)- and amyloid PET-derived features may serve as useful screening tools for tau pathology. Multiple machine learning models were developed to classify tau positivity in the Braak III/IV region using structural MRI, amyloid PET, and demographic features. Alzheimer's Disease Neuroimaging Initiative (ADNI) (…

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By August 2026, researchers had trained machine learning models on ADNI data to predict tau PET positivity from more accessible MRI and amyloid PET features, then tested them on OASIS-3 and SCAN cohorts. Logistic regression reached AUCs of 0.92 in both internal and external validation, with combined external accuracy of 85%.
The result matters because tau PET is effective but limited clinically by cost and availability, so an MRI-based surrogate could expand screening in amyloid-positive populations. It remains uncertain how the model would perform outside research cohorts, across diverse clinical settings, and whether predicted tau status would change care decisions or outcomes.
- Model trained on ADNI n=410 and externally validated on OASIS-3 n=143 and SCAN n=154 using MRI, amyloid PET, and demographic features.
- Logistic regression was best performing model with AUC 0.92 internally and externally and 85%/83%/85% accuracy/sensitivity/specificity combined.
- Subjects with mild cognitive impairment and predicted tau positivity progressed to AD at significantly faster pace with p < 10-6.
Machine learning models using structural MRI, amyloid PET, and demographic features can classify tau positivity in the Braak III/IV region in amyloid-positive cohorts, achieving AUC 0.92 and 85% accuracy on external validation.
The rundown
Researchers developed multiple machine learning models to classify tau positivity in the Braak III/IV region using structural MRI, amyloid PET, and demographic features, training on Alzheimer's Disease Neuroimaging Initiative data with n=410.
External validation used Open Access Series of Imaging Studies n=143 and Standardized Centralized Alzheimer's Disease Neuroimaging n=154, where logistic regression outperformed other models and predicted tau positivity was associated with faster progression from mild cognitive impairment to AD.
Sources
- Peer-reviewedAlzheimer's & Dementia2026-08-01
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