The Spatial-Temporal Ordering of Amyloid Pathology and Opportunities for PET Imaging
The Spatial-Temporal Ordering of Amyloid Pathology and Opportunities for PET Imaging
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DOI：
10.2967/jnumed.119.235879
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发表时间：
2020-02-01
影响因子：
9.3
通讯作者：
Farrar, Gill
中科院分区：
文献类型：
--
作者：
Fantoni, Enrico;Collij, Lyduine;Farrar, Gill
尽管临床常规侧重于淀粉样蛋白 PET 的二分法和视觉解释，但研究环境中的区域图像评估可能会产生更多机会。了解淀粉样蛋白病理学的区域-时间演变可能有助于更早地识别阿尔茨海默病病理学连续体中的受试者，以及超越传统二分法测量的更细粒度的病理学评估。本综述总结了当前检测区域淀粉样蛋白沉积模式的研究及其对淀粉样蛋白病理分期的潜力。包括病理学研究、横断面和纵向 PET 研究以及比较 PET 和尸检研究。尽管存在某些差异，皮质沉积通常先于纹状体病理发生，并且在仅 PET 研究中，发现内侧皮质区域比外侧区域更早积累淀粉样蛋白。基于区域淀粉样蛋白 PET，多项研究开发并实施了淀粉样蛋白病理分期模型，可以改善二级预防试验的受试者选择和临床常规中的视觉评估。
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.