随着抗淀粉样蛋白疗法的获批，阿尔茨海默病（AD）的早期诊断与精准治疗已成为临床关注的焦点。近期，王瑞民教授在《Molecular Imaging in Alzheimer's Disease: PET Technology for Early Detection and Precision Medicine》一文中系统回顾了正电子发射断层扫描（PET）分子影像在AD早期诊断、鉴别诊断及精准治疗中的关键作用。

This review highlights the transformative impact of positron emission tomography (PET) in Alzheimer’s disease (AD) management. With the recent approval of anti-amyloid therapies, in vivo detection of AD pathology has become a clinical necessity. The article systematically examines the evolution and clinical application of amyloid-β (Aβ) and Tau PET tracers, including the recent approval of 18F-florbetaben in China.

研究指出，PET技术通过特异性示踪剂（如Aβ-PET与Tau-PET）实现了AD病理的可视化与定量分析，为临床提供了可靠的生物标志物检测手段。特别是随着18F-florbetaben在中国获批，Aβ-PET成像已逐步进入临床常规应用，其高灵敏度与特异性为AD的早期筛查提供了有力工具。文章进一步阐述了PET在ATN（淀粉样蛋白/Tau/神经退行性变）框架中的应用价值，通过双示踪成像（Aβ+Tau）可实现AD的精准分期、鉴别诊断（如与额颞叶痴呆的区分）及预后评估。研究还提供了临床PET解读的标准化流程，包括视觉评估方法与Centiloid定量分析，并针对抗Aβ免疫治疗（如lecanemab、donanemab）的疗效监测提出了具体的影像随访方案。

PET enables visual and quantitative assessment of amyloid and Tau pathology within the ATN framework, facilitating early diagnosis, differential diagnosis, and staging of AD. Standardized interpretation methods, such as the Centiloid scale, and practical protocols for therapy monitoring are discussed. The integration of dual Aβ and Tau PET imaging provides a multidimensional view of disease progression, enhancing personalized treatment strategies.

尽管PET成像在AD诊断中展现出显著优势，作者也指出其在多中心数据标准化、示踪剂特异性提升、共病理成像等方面仍面临挑战。未来，通过多学科协作、人工智能与液体标志物融合，PET将在AD的个性化医疗中发挥更重要的作用。

Despite advances, challenges remain in harmonizing multicenter data, developing tracers for co-pathologies, and integrating PET with fluid biomarkers and AI. This review underscores PET’s indispensable role in advancing precision medicine for AD, offering a roadmap for future research and clinical implementation.

Tau PET生物学分期