PET imaging utilization for Alzheimer's disease diagnosis and management in China

With the rapid aging of the population, Alzheimer's disease (AD) presents an increasingly severe challenge to public health in China. Early diagnosis and treatment are critical strategies for slowing the progression of the disease. The development of positron emission tomography (PET) has made it possible to visualize the key pathological mechanisms of AD, significantly advancing research in this field. This review examines the current landscape of PET imaging applications in AD in China, highlighting advancements in molecular probes, diagnostic frameworks, and translational research. 18 F-fluorodeoxyglucose ( 18 F-FDG) PET serves as a foundational tool for assessing cerebral glucose metabolism and has established itself as an early method for detecting the characteristic hypometabolic patterns associated with AD. The subsequent advent and clinical integration of amyloid-β (Aβ) PET ligands marked a transformative shift, enabling the in vivo detection of core AD neuropathology and significantly enhancing diagnostic accuracy. More recently, the introduction of tau PET tracers has facilitated the precise mapping of neurofibrillary tangle deposition, providing a more comprehensive pathological picture. This review also emphasizes the increasing importance of multimodal imaging approaches, which integrate PET data with magnetic resonance imaging (MRI) and other modalities to bolster diagnostic confidence and prognostic evaluation. This synergy is encapsulated in the A/T/(N) (Aβ, tau, and neurodegeneration) framework, a biomarker-based classification system that is increasingly guiding clinical research and trial enrollment in China. Finally, exploration of PET imaging with novel radiotracers targeting emerging pathological processes in China, holds immense promise for uncovering deeper insights into disease mechanisms and monitoring therapeutic efficacy.