Amyloid Imaging Techniques in Neurodegenerative Diseases

Amyloid imaging has transformed the diagnosis and monitoring of neurodegenerative diseases by enabling the in vivo detection of β-amyloid deposits, a pathological hallmark of Alzheimer’s disease and related syndromes. Positron emission tomography (PET) with radiotracers such as [11C]Pittsburgh Compound‐B, [18F]florbetaben, [18F]florbetapir and [18F]flutemetamol allows visual and quantitative assessment of amyloid load. Quantitative approaches—most notably the Centiloid scale—standardise uptake measures across centres and tracers, facilitating comparison of amyloid burden in clinical trials and routine practice. Advances in image processing, including automated region‐of‐interest delineation and partial volume correction, have improved sensitivity for early and regional amyloid accumulation. Emerging machine‐learning methods and multimodal integration with structural MRI and tau PET further refine the spatial and temporal characterisation of amyloid deposition. Together, these techniques support early diagnosis, stratification of prodromal cases, monitoring of disease progression and evaluation of anti‐amyloid therapies on a global scale.

Research from Nature Portfolio

Recent studies have elucidated the earliest loci of amyloid accumulation and its network‐level consequences. Using longitudinal PET and cerebrospinal fluid biomarkers, researchers have shown that amyloid fibrils begin to accumulate preferentially within core nodes of the default‐mode network—specifically the precuneus, medial orbitofrontal and posterior cingulate cortices—before overt clinical symptoms. This early pattern is detectable even when fluid biomarkers remain within normal limits. Concurrent declines in functional connectivity within and between the default‐mode and frontoparietal networks have been demonstrated, indicating that nascent amyloid deposition disrupts brain networks prior to substantial neurodegeneration. These findings offer insight into preclinical staging and highlight target regions for early intervention and trial enrolment.

Amyloid Imaging Techniques in Neurodegenerative Diseases publication trend

The graph below shows the total number of articles in amyloid imaging techniques in neurodegenerative diseases across all publications each year (not limited to Nature Index journals).

Technical terms

Positron Emission Tomography (PET): A molecular imaging technique using radiolabelled tracers to visualise and quantify pathological processes, including amyloid‐β deposition in the brain.

Centiloid Scale: A standardised unit for reporting amyloid PET tracer uptake, calibrated so that 0 represents young controls and 100 represents typical Alzheimer’s pathology.

Florbetaben: An ^18F‐labelled radiotracer that binds selectively to β‐amyloid plaques, enabling their detection by PET.

Default‐Mode Network (DMN): A network of brain regions that are metabolically active at rest; early amyloid deposition within the DMN is associated with preclinical disease.

Standardised Uptake Value Ratio (SUVR): The ratio of tracer uptake in a region of interest to a reference region, used for semi‐quantitative PET analysis.

References

1. Earliest accumulation of β-amyloid occurs within the default-mode network and concurrently affects brain connectivity. Nature Communications (2017).
2. Clinical Effect of Early vs Late Amyloid Positron Emission Tomography in Memory Clinic Patients. JAMA Neurology (2023).
3. Amyloid-PET imaging predicts functional decline in clinically normal individuals. Alzheimer's Research & Therapy (2024).
4. Validation of quantitative assessment of florbetaben PET scans as an adjunct to the visual assessment across 15 software methods. European Journal of Nuclear Medicine and Molecular Imaging (2023).