Advances in diagnostic imaging of the glial lymphatic system in Alzheimer's Disease

The glial lymphatic system (GLS) is responsible for removing metabolic waste and aberrantly deposited substances from brain by exchanging materials with interstitial fluid (ISF), thereby maintaining cerebral homeostasis. Dysfunction in this system can result in the abnormal accumulation of amyloid-beta (Aβ) and tau proteins, leading to cognitive impairments. Recent advancements in neuroimaging have enhanced the evaluation of GLS function, forming a vital component of Alzheimer's disease (AD) diagnostics. This article offers a comprehensive overview of the imaging performance of various methods used to visualize the glial lymphatic system in Alzheimer's disease (AD), highlighting their respective advantages and limitations. • The last sentence of the abstract section has been streamlined; • The advantages or limitations of each imaging method have been added at the end of the paragraph for each imaging method and summarized before Combination of Multimodal Imaging, and a concise summary has been added to Fig. 2 ; • Revised Fig. 1 based on reviewer#2's comments; • Summarized and made feasibility recommendations in the Conclusion and outlook section; • Made adjustments in the Fund section by removing one item and adding another;