Quantification of amyloid PET for future clinical use: a state-of-the-art review

作者：Hugh Pemberton, Lyduine E. Collij, Fiona Heeman, Ariane Bollack, Mahnaz Shekari, Gemma Salvadó, Isadora Lopes Alves, David Vállez García, Mark Battle, Christopher Buckley, Andrew Stephens, Santiago Bullich, Valentina Garibotto, Frederik Barkhof, Juan Domingo Gispert, Gill Farrar · 发表于：European Journal of Nuclear Medicine and Molecular Imaging · 年份：2022 · DOI：10.1007/s00259-022-05784-y · 被引用次数：229 · 研究领域：Medical Imaging Techniques and Applications、Alzheimer's disease research and treatments、Lanthanide and Transition Metal Complexes

Amyloid-β (Aβ) pathology is one of the earliest detectable brain changes in Alzheimer's disease (AD) pathogenesis. The overall load and spatial distribution of brain Aβ can be determined in vivo using positron emission tomography (PET), for which three fluorine-18 labelled radiotracers have been approved for clinical use. In clinical practice, trained readers will categorise scans as either Aβ positive or negative, based on visual inspection. Diagnostic decisions are often based on these reads and patient selection for clinical trials is increasingly guided by amyloid status. However, tracer deposition in the grey matter as a function of amyloid load is an inherently continuous process, which is not sufficiently appreciated through binary cut-offs alone. State-of-the-art methods for amyloid PET quantification can generate tracer-independent measures of Aβ burden. Recent research has shown the ability of these quantitative measures to highlight pathological changes at the earliest stages of the AD continuum and generate more sensitive thresholds, as well as improving diagnostic confidence around established binary cut-offs. With the recent FDA approval of aducanumab and more candidate drugs on the horizon, early identification of amyloid burden using quantitative measures is critical for enrolling appropriate subjects to help establish the optimal window for therapeutic intervention and secondary prevention. In addition, quantitative amyloid measurements are used for treatment...