Abstract
In vivo imaging of brain amyloid using positron emission tomography (PET) scanning is widely used in research studies of dementia, with three amyloid PET ligands being licenced for clinical use. The main clinical use of PET is to help confirm or exclude the likely diagnosis of Alzheimer’s disease in challenging cases, where diagnostic uncertainty remains after current clinical and investigative work up. Whilst diagnostically valuable in such select cases, much wider clinical adoption, especially for very early disease, will be limited by both cost and the lack of a currently effective disease-modifying treatment that requires such early case identification. The use of amyloid imaging to appropriately stratify subjects for prognostic studies and therapeutic trials should increase the efficiency and potentially shorten the time of such studies, and its use combined with other biomarkers and genetics will likely lead to new ways of defining and classifying the dementias.
Highlights
Recent advances in brain imaging have transformed the way we think about, understand, and characterise Alzheimer’s disease and other dementias
Use of amyloid imaging Amyloid imaging has been rapidly adopted by the research community, for obvious reasons, including determining when and how amyloid deposition builds up in the brain, how it relates to clinical symptoms and progression, and defining its temporal relationships with other key pathological aspects of the disease such as tau deposition, structural brain atrophy, and neuroinflammation
O’Brien and Herholz BMC Medicine (2015) 13:163 to clinical symptoms. Whilst this fits with the hypothesis that amyloid deposition occurs first, recent studies have suggest that some people with Alzheimer’s disease may present with more tau-focused neurodegenerative change prior to evidence of substantial amyloid deposition, at least on brain imaging [7]
Summary
Background Recent advances in brain imaging have transformed the way we think about, understand, and characterise Alzheimer’s disease and other dementias. Use of amyloid imaging Amyloid imaging has been rapidly adopted by the research community, for obvious reasons, including determining when and how amyloid deposition builds up in the brain, how it relates to clinical symptoms and progression, and defining its temporal relationships with other key pathological aspects of the disease such as tau deposition, structural brain atrophy, and neuroinflammation. Whilst this fits with the hypothesis that amyloid deposition occurs first, recent studies have suggest that some people with Alzheimer’s disease may present with more tau-focused neurodegenerative change prior to evidence of substantial amyloid deposition, at least on brain imaging [7].
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