From diagnosis to therapy: Integrating Aβ and tau PET into clinical practice for Alzheimer's disease

This review comprehensively delineates the pivotal role of positron emission tomography (PET) molecular imaging in the early detection, differential diagnosis, and precision medicine management of Alzheimer's disease (AD). With the recent approval of disease-modifying anti-amyloid therapies, the in vivo detection of AD pathology has transitioned from a research goal to a clinical necessity. This review traces the evolution and clinical application of β-amyloid (Aβ) PET tracers, including the recent approval of 18 F-florbetaben in China, and provides a balanced overview of tau PET tracers (e.g., 18 F-flortaucipir, 18 F-MK-6240) and their utility within the ATN (amyloid/tau/ neurodegeneration) framework. It offers practical guidance on patient selection for PET imaging, standardized visual and quantitative interpretation methods (e.g., the Centiloid scale), and provides protocol recommendations for therapy monitoring, supported by data from pivotal trials. Finally, the integration of dual Aβ and tau PET imaging for staging and prognosis, existing challenges, and future directions are discussed, underscoring the indispensable role of PET in advancing personalized care for AD.