Journal
JOURNAL OF NUCLEAR MEDICINE
Volume 61, Issue 2, Pages 166-171Publisher
SOC NUCLEAR MEDICINE INC
DOI: 10.2967/jnumed.119.235879
Keywords
amyloid PET; staging; spatial-temporal ordering; pathology
Funding
- Innovative Medicines Initiative 2 Joint Undertaking [115952]
- European Union's Horizon 2020 research and innovation program
- EFPIA
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Although clinical routine focuses on dichotomous and visual interpretation of amyloid PET, regional image assessment in research settings may yield additional opportunities. Understanding the regional-temporal evolution of amyloid pathology may enable earlier identification of subjects in the Alzheimer Disease pathologic continuum, as well as a finer-grained assessment of pathology beyond traditional dichotomous measures. This review summarizes current research in the detection of regional amyloid deposition patterns and its potential for staging amyloid pathology. Pathology studies, cross-sectional and longitudinal PET-only studies, and comparative PET and autopsy studies are included. Despite certain differences, cortical deposition generally precedes striatal pathology, and in PET-only studies, medial cortical regions are seen to accumulate amyloid earlier than lateral regions. Based on regional amyloid PET, multiple studies have developed and implemented models for staging amyloid pathology that could improve subject selection into secondary prevention trials and visual assessment in clinical routine.
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