Role of amyloid positron emission tomography (PET) imaging in early diagnosis and treatment of Alzheimer’s disease: a literature review

Trương Diệp Vân Anh 1 ,
1 Can Tho University of Medicine and Pharmacy image/svg+xml
* Corresponding author:

Article Information

Metrics
Downloads: 21 Views: 40
DOI
10.63947/bvtn.v2i9.3
Crossmark
Published
2026-10-01
Issue Vol. 2 No. 9 (2026): A Major Step Forward in Specialized Care: A Milestone Marked by the First Liver Transplant at Thong Nhat Hospital
Section
Review Article

Download Article

PDF (Vietnamese)

How to Cite

1.
Trương DVA. Role of amyloid positron emission tomography (PET) imaging in early diagnosis and treatment of Alzheimer’s disease: a literature review. JHA [Internet]. Vietnam; 2026 Oct. 1 [cited 2026 Oct. 16];2(9):22–32. https://tcsuckhoelaohoa.vn/bvtn/article/view/206 doi: 10.63947/bvtn.v2i9.3
Loading citation...
Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Alzheimer’s disease (AD) is becoming a global health burden, necessitating a shift in diagnostic models from traditional clinical criteria to biomarkers based on the ATN classification system. This review aims to synthesize scientific evidence regarding the role of amyloid positron emission tomography (PET) in the early diagnosis and management of AD. Amyloid-PET enables the quantification of amyloid-beta (Aβ) plaque deposition in the living brain — a biological process that begins 15-20 years before symptom onset. The article reviews the development from the first-generation compound 11C-PiB to 18F-labeled radiotracers (Florbetapir, Flutemetamol, Florbetaben), which have made this technique feasible in routine clinical practice. Notably, amyloid-PET serves as an indispensable “gold standard” for patient selection and monitoring the plaque-clearing efficacy of novel immunotherapies such as Lecanemab and Donanemab. Finally, the paper discusses challenges in Vietnam and proposes a multimodal coordination model, utilizing blood-based biomarkers for screening followed by amyloid-PET for confirmation, to optimize costs and enhance diagnostic efficiency within the local context.

Keywords

Amyloid-PET Alzheimer’s disease biomarkers ATN framework immunotherapy

References

  1. Scheltens P, De Strooper B, Kivipelto M, Holstege H, Chételat G, Teunissen CE, Cummings J, Van Der Flier WM. Alzheimer’s disease. The Lancet. 2021;397(10284):1577–1590. doi:10.1016/S0140-6736(20)32205-4 DOI: https://doi.org/10.1016/S0140-6736(20)32205-4
  2. Jack CR, Knopman DS, Jagust WJ, Petersen RC, Weiner MW, Aisen PS, Shaw LM, Vemuri P, Wiste HJ, Weigand SD, et al. Tracking pathophysiological processes in Alzheimer’s disease: an updated hypothetical model of dynamic biomarkers. The Lancet Neurology. 2013;12(2):207–216. doi:10.1016/S1474-4422(12)70291-0 DOI: https://doi.org/10.1016/S1474-4422(12)70291-0
  3. Hansson O, Blennow K, Zetterberg H, Dage J. Blood biomarkers for Alzheimer’s disease in clinical practice and trials. Nature Aging. 2023;3(5):506–519. doi:10.1038/s43587-023-00403-3 DOI: https://doi.org/10.1038/s43587-023-00403-3
  4. Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, Holtzman DM, Jagust W, Jessen F, Karlawish J, et al. NIA‐AA Research Framework: Toward a biological definition of Alzheimer’s disease. Alzheimer’s & Dementia. 2018;14(4):535–562. doi:10.1016/j.jalz.2018.02.018 DOI: https://doi.org/10.1016/j.jalz.2018.02.018
  5. Villemagne VL, Doré V, Burnham SC, Masters CL, Rowe CC. Imaging tau and amyloid-β proteinopathies in Alzheimer disease and other conditions. Nature Reviews Neurology. 2018;14(4):225–236. doi:10.1038/nrneurol.2018.9 DOI: https://doi.org/10.1038/nrneurol.2018.9
  6. Villemagne VL, Burnham S, Bourgeat P, Brown B, Ellis KA, Salvado O, Szoeke C, Macaulay SL, Martins R, Maruff P, et al. Amyloid β deposition, neurodegeneration, and cognitive decline in sporadic Alzheimer’s disease: a prospective cohort study. The Lancet Neurology. 2013;12(4):357–367. doi:10.1016/S1474-4422(13)70044-9 DOI: https://doi.org/10.1016/S1474-4422(13)70044-9
  7. Klunk WE, Engler H, Nordberg A, Wang Y, Blomqvist G, Holt DP, Bergström M, Savitcheva I, Huang G, Estrada S, et al. Imaging brain amyloid in Alzheimer’s disease with Pittsburgh Compound‐B. Annals of Neurology. 2004;55(3):306–319. doi:10.1002/ana.20009 DOI: https://doi.org/10.1002/ana.20009
  8. Nádia Canário, Lília Jorge, Ricardo Martins & Miguel Castelo-Branco. Dual PET-fMRI reveals a link between neuroinflammation, amyloid binding and compensatory task-related brain activity in Alzheimer’s disease. Commun Biol. 2022;5:801. doi:10.1038/s42003-022-03761-7 DOI: https://doi.org/10.1038/s42003-022-03761-7
  9. Clark CM. Use of Florbetapir-PET for Imaging β-Amyloid Pathology. JAMA. 2011;305(3):275. doi:10.1001/jama.2010.2008 DOI: https://doi.org/10.1001/jama.2010.2008
  10. Barthel H, Gertz H-J, Dresel S, Peters O, Bartenstein P, Buerger K, Hiemeyer F, Wittemer-Rump SM, Seibyl J, Reininger C, et al. Cerebral amyloid-β PET with florbetaben (18F) in patients with Alzheimer’s disease and healthy controls: a multicentre phase 2 diagnostic study. The Lancet Neurology. 2011;10(5):424–435. doi:10.1016/S1474-4422(11)70077-1 DOI: https://doi.org/10.1016/S1474-4422(11)70077-1
  11. Thal DR, Beach TG, Zanette M, Heurling K, Chakrabarty A, Ismail A, Smith APL, Buckley C. [18 F]flutemetamol amyloid positron emission tomography in preclinical and symptomatic Alzheimer’s disease: Specific detection of advanced phases of amyloid‐β pathology. Alzheimer’s & Dementia. 2015;11(8):975–985. doi:10.1016/j.jalz.2015.05.018 DOI: https://doi.org/10.1016/j.jalz.2015.05.018
  12. Chételat G, Arbizu J, Barthel H, Garibotto V, Law I, Morbelli S, Van De Giessen E, Agosta F, Barkhof F, Brooks DJ, et al. Amyloid-PET and 18F-FDG-PET in the diagnostic investigation of Alzheimer’s disease and other dementias. The Lancet Neurology. 2020;19(11):951–962. doi:10.1016/S1474-4422(20)30314-8 DOI: https://doi.org/10.1016/S1474-4422(20)30314-8
  13. Doré V, Bullich S, Rowe CC, Bourgeat P, Konate S, Sabri O, Stephens AW, Barthel H, Fripp J, Masters CL, et al. Comparison of18 F‐florbetaben quantification results using the standard Centiloid, MR‐based, and MR‐less CapAIBL® approaches: Validation against histopathology. Alzheimer’s & Dementia. 2019;15(6):807–816. doi:10.1016/j.jalz.2019.02.005 DOI: https://doi.org/10.1016/j.jalz.2019.02.005
  14. Tahami Monfared AA, Byrnes MJ, White LA, Zhang Q. Alzheimer’s Disease: Epidemiology and Clinical Progression. Neurol Ther. 2022;11(2):553-569. doi:10.1007/s40120-022-00338-8 DOI: https://doi.org/10.1007/s40120-022-00338-8
  15. Jack CR, Andrews JS, Beach TG, et al. Revised criteria for diagnosis and staging of Alzheimer's disease: Alzheimer's Association Workgroup. Alzheimers Dement. 2024;20:5143-69. doi:10.1002/alz.13859 DOI: https://doi.org/10.1002/alz.13859
  16. Safiri S, Ghaffari Jolfayi A, Fazlollahi A, Morsali S, Sarkesh A, Daei Sorkhabi A, Golabi B, Aletaha R, Motlagh Asghari K, Hamidi S, et al. Alzheimer’s disease: a comprehensive review of epidemiology, risk factors, symptoms diagnosis, management, caregiving, advanced treatments and associated challenges. Frontiers in Medicine. 2024;11:1474043. doi:10.3389/fmed.2024.1474043 DOI: https://doi.org/10.3389/fmed.2024.1474043
  17. Van Dyck CH, Swanson CJ, Aisen P, Bateman RJ, Chen C, Gee M, Kanekiyo M, Li D, Reyderman L, Cohen S, et al. Lecanemab in Early Alzheimer’s Disease. New England Journal of Medicine. 2023;388(1):9–21. doi:10.1056/NEJMoa2212948 DOI: https://doi.org/10.1056/NEJMoa2212948
  18. Mintun MA, Lo AC, Duggan Evans C, Wessels AM, Ardayfio PA, Andersen SW, Shcherbinin S, Sparks J, Sims JR, Brys M, et al. Donanemab in Early Alzheimer’s Disease. New England Journal of Medicine. 2021;384(18):1691–1704. doi:10.1056/NEJMoa2100708 DOI: https://doi.org/10.1056/NEJMoa2100708
  19. Rabinovici GD, Gatsonis C, Apgar C, Chaudhary K, Gareen IF, Hanna L, et al. Association of Amyloid Positron Emission Tomography With Subsequent Change in Clinical Management Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia. JAMA. 2019;321(13):1286-1294. doi:10.1001/jama.2019.2000 DOI: https://doi.org/10.1001/jama.2019.2000
  20. Rabinovici GD, Knopman DS, Arbizu J, Benzinger TLS, Donohoe KJ, Hansson O, et al. Updated appropriate use criteria for amyloid and tau PET: A report from the Alzheimer’s Association and Society for Nuclear Medicine and Molecular Imaging Workgroup. Alzheimers Dement. 2025;21(1):e14338. doi:10.1002/alz.14338 DOI: https://doi.org/10.1002/alz.14338

License

© 2026 The Author(s). Published by Journal of Health and Aging.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.