Abstract
Several radiotracers have been employed to bind amyloid plaques in the brain for the differential diagnosis of neurodegenerative disease, open the possibility to measure in vivo pathogenic processes implicated in Alzheimer disease (AD) and have the potential to detect disease processes at the earliest stages with a potential role in clinical trials’ longitudinal assessment. Visual reading is clinically adequate in clearly positive or negative cases but the adoption of validated and standardized quantification methods of amyloid-PET to diagnose AD in research and clinical settings has become essential. The present Pictorial Essay presenting a case series of nine patients describes the current role of amy-PET imaging elucidating the typical assessment, the possible artifacts and pitfalls occurring in the clinical scenario, focusing also on the development of quantification methods in the diagnostic workup of neurodegenerative disease.
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Dubois B, Feldman HH, Jacova C, Hampel H, Molinuevo JL, Blennow K et al (2014) Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 13(6):614–629
McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR, Kawas CH et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7(3):263–269
Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH, Fox NC et al (2011) The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7(3):270–279
Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB et al (2018) NIA-AA research framework: toward a biological definition of Alzheimer’s disease. Alzheimer’s Dement 14:535–562
Chiotis K, Saint-Aubert L, Boccardi M, Gietl A, Picco A, Varrone A et al (2017) Clinical validity of increased cortical uptake of amyloid ligands on PET as a biomarker for Alzheimer’s disease in the context of a structured 5-phase development framework. Neurobiol Aging 52:214–227
Iaccarino L, Chiotis K, Alongi P, Almkvist O, Wall A, Cerami C et al (2017) A cross-validation of FDG-and amyloid-PET biomarkers in mild cognitive impairment for the risk prediction to dementia due to Alzheimer’s disease in a clinical setting. J Alzheimer’s Dis 59(2):603–614
Morris E, Chalkidou A, Hammers A, Peacock J, Summers J, Keevil S (2016) Diagnostic accuracy of (18)F amyloid PET tracers for the diagnosis of Alzheimer’s disease: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 43(2):374–385
Shea YF, Barker W, Greig-Gusto MT, Loewenstein DA, Duara R, Dekosky ST (2018) Impact of amyloid PET imaging in the memory clinic: a systematic review and meta-analysis. J Alzheimer’s Dis 64(1):323–335
Chincarini A, Peira E, Corosu M, Morbelli S, Bauckneht M, Capitanio S et al (2020) A kinetics-based approach to amyloid PET semi-quantification. Eur J Nucl Med Mol Imaging 47(9):2175–2185
Chincarini A, Peira E, Morbelli S, Pardini M, Bauckneht M, Arbizu J et al (2019) Semi-quantification and grading of amyloid PET: a project of the European Alzheimer’s Disease Consortium (EADC). NeuroImage Clin 23:101846
Alongi P, Sardina DS, Coppola R, Scalisi S, Puglisi V, Arnone A et al (2019) 18F-Florbetaben PET/CT to assess Alzheimer’s Disease: a new analysis method for regional amyloid quantification. J Neuroimaging 29(3):383–393
Boccardi M, Nicolosi V, Festari C, Bianchetti A, Cappa S, Chiasserini D et al (2020) Italian consensus recommendations for a biomarker-based aetiological diagnosis in mild cognitive impairment patients. Eur J Neurol 27(3):475–483
Chételat G, Arbizu J, Barthel H, Garibotto V, Law I, Morbelli S et al (2020) Amyloid-PET and 18F-FDG-PET in the diagnostic investigation of Alzheimer’s disease and other dementias. Lancet Neurol 19:951–962
Minoshima S, Drzezga AE, Barthel H, Bohnen N, Djekidel M, Lewis DH et al (2016) SNMMI procedure standard/EANM practice guideline for amyloid PET imaging of the brain 10. J Nucl Med 57(8):1316–1322
Chincarini A, Sensi F, Rei L, Bossert I, Morbelli S, Guerra UP et al (2016) Standardized uptake value ratio-independent evaluation of brain amyloidosis. J Alzheimer’s Dis. 54(4):1437–1457
Collij LE, Salvadó G, Shekari M, Alves IL, Reimand J, Wink AM et al (2021) Visual assessment of [18F]flutemetamol PET images can detect early amyloid pathology and grade its extent. Eur J Nucl Med Mol Imaging 48(7):2169–2182
Peira E, Grazzini M, Bauckneht M, Sensi F, Bosco P, Arnaldi D et al (2021) Probing the role of a regional quantitative assessment of amyloid PET. J Alzheimer’s Dis 80(1):383–396
Presotto L, Iaccarino L, Sala A, Vanoli EG, Muscio C, Nigri A et al (2018) Low-dose CT for the spatial normalization of PET images: a validation procedure for amyloid-PET semi-quantification. NeuroImage Clin 20:153–160
Burnham SC, Bourgeat P, Doré V, Savage G, Brown B, Laws S et al (2016) Clinical and cognitive trajectories in cognitively healthy elderly individuals with suspected non-Alzheimer’s disease pathophysiology (SNAP) or Alzheimer’s disease pathology: a longitudinal study. Lancet Neurol 15(10):1044–1053
Dani M, Brooks DJ, Edison P (2017) Suspected non Alzheimer’s pathology—is it non-Alzheimer’s or non-amyloid? Ageing Res Rev 36:20–31
Mattsson N, Carrillo MC, Dean RA, Devous MD, Nikolcheva T, Pesini P et al (2015) Revolutionizing Alzheimer’s disease and clinical trials through biomarkers. Alzheimer’s Dement Diagn Assess Dis Monit 1:412–419
Leuzy A, Savitcheva I, Chiotis K, Lilja J, Andersen P, Bogdanovic N et al (2019) Clinical impact of [18 F]flutemetamol PET among memory clinic patients with an unclear diagnosis. Eur J Nucl Med Mol Imaging 46(6):1276–1286
Haq EU, Huang J, Kang L, Haq HU, Zhan T (2020) Image-based state-of-the-art techniques for the identification and classification of brain diseases: a review. Med Biol Eng Comput 58:2603–2620
Ramusino MC, Garibotto V, Bacchin R, Altomare D, Dodich A, Assal F et al (2020) Incremental value of amyloid-PET versus CSF in the diagnosis of Alzheimer’s disease. Eur J Nucl Med Mol Imaging. 47(2):270–280
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Alongi, P., Chiaravalloti, A., Berti, V. et al. Amyloid PET in the diagnostic workup of neurodegenerative disease. Clin Transl Imaging 9, 383–397 (2021). https://doi.org/10.1007/s40336-021-00428-x
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DOI: https://doi.org/10.1007/s40336-021-00428-x