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Hybrid PET/MRI Imaging of Alzheimer's Disease Based on 18F-AV-1451
Published on: April 18, 2025
Disease stage-specific atrophy markers in Alzheimer's disease
Hannah Baumeister1, Helena M Gellersen1,2,3, Sarah E Polk1
1German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
Introduction:
Structural MRI often lacks diagnostic, prognostic, and monitoring value in Alzheimer's disease (AD), particularly in early disease stages. To improve its utility, we aimed to identify optimal MRI readouts for different use cases.
Methods:
We included 363 older adults; healthy controls (HC) who were negative or positive for amyloidbeta (Aβ) and Aβ-positive patients with subjective cognitive decline (SCD), mild cognitive impairment, or dementia of the Alzheimer type. MRI and neuropsychological assessments were administered annually for up to three years.
Results:
Accelerated atrophy of distinct MTL subregions was evident already during preclinical AD. Symptomatic disease stages most notably differed in their hippocampal and parietal atrophy signatures. Associations of atrophy markers and cognitive inventories varied by intended use and disease stage.
Discussion:
With the appropriate readout, MRI can detect abnormal atrophy already during preclinical AD. To optimize performance, MRI readouts should be tailored to the targeted disease stage and intended use.
Insights
Structural MRI can detect early Alzheimer's disease (AD) atrophy. Tailoring MRI readouts to the specific disease stage and use case optimizes diagnostic and prognostic value for AD.
Area of Science:
- Neuroimaging
- Alzheimer's Disease Research
Background:
- Structural MRI has limited diagnostic utility in early Alzheimer's disease (AD).
- Improving MRI's value for diagnosis, prognosis, and monitoring in AD is crucial.
Purpose of the Study:
- To identify optimal MRI readouts for various applications in Alzheimer's disease.
- To enhance the utility of structural MRI in different stages of AD.
Main Methods:
- Included 363 older adults: healthy controls (amyloid-beta negative/positive) and amyloid-beta positive individuals with cognitive decline.
- Annual MRI and neuropsychological assessments were conducted for up to three years.
Main Results:
- Accelerated atrophy in medial temporal lobe (MTL) subregions was observed during preclinical AD.
- Distinct hippocampal and parietal atrophy patterns characterized symptomatic AD stages.
- Atrophy marker associations with cognitive scores differed by disease stage and intended use.
Conclusions:
- MRI can detect abnormal atrophy in preclinical AD with appropriate readouts.
- Tailoring MRI readouts to the targeted disease stage and use case is essential for optimizing performance.
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