Currently, 3 amyloid PET tracers are approved and commercially available for clinical use. They allow for the accurate in vivo detection of amyloid plaques, one hallmark of Alzheimer disease. Here, we review the current knowledge on the clinical use and utility of amyloid imaging. Appropriate use criteria for the clinical application of amyloid imaging are established, and most currently available data point to their validity. Visual amyloid image analysis is highly standardized. Disclosure of amyloid imaging results is desired by many cognitively impaired subjects and seems to be safe once appropriate education is delivered to the disclosing clinicians. Regarding clinical utility, increasing evidence points to a change in diagnosis via amyloid imaging in about 30% of cases, to an increase in diagnostic confidence in about 60% of cases, to a change in patient management in about 60% of cases, and specifically to a change in medication in about 40% of cases. Also, amyloid imaging results seem to have a relevant impact on caregivers. Further, initial simulation studies point to a potential positive effect on patient outcome and to cost effectiveness of amyloid imaging. These features, however, will require confirmation in prospective clinical trials. More work is also required to determine the clinical utility of amyloid imaging specifically in subjects with mild cognitive impairment and in comparison with or in conjunction with other Alzheimer disease biomarkers. In summary, the clinical use of amyloid imaging is being studied, and the currently available data point to a relevant clinical utility of this imaging technique. Ongoing research will determine whether this accurate and noninvasive approach to amyloid plaque load detection will translate into a benefit to cognitively impaired subjects.

目前，已批准了3种淀粉样蛋白PET示踪剂，可用于临床。它们可以对淀粉样蛋白斑进行准确的体内检测，这是阿尔茨海默氏病的标志之一。在这里，我们回顾了有关淀粉样蛋白成像的临床使用和实用性的当前知识。建立了淀粉样蛋白成像临床应用的适当使用标准，并且大多数当前可用的数据指出了它们的有效性。视觉淀粉样蛋白图像分析是高度标准化的。淀粉样蛋白成像结果的披露是许多认知障碍受试者所希望的，并且一旦对披露的临床医生进行了适当的教育，似乎是安全的。关于临床用途，越来越多的证据表明，约30％的病例通过淀粉样蛋白成像进行诊断改变，约60％的病例表明诊断置信度提高，在大约60％的情况下会改变患者管理，尤其是在大约40％的情况下会改变药物治疗。同样，淀粉样蛋白成像结果似乎对护理人员有相关影响。此外，初步的模拟研究指出了对患者预后的潜在积极影响，并指出了淀粉样蛋白成像的成本效益。但是，这些功能需要在前瞻性临床试验中进行确认。还需要更多的工作来确定淀粉样蛋白成像的临床效用，特别是在患有轻度认知障碍的受试者中，以及与其他阿尔茨海默氏病生物标志物或与之结合使用。总而言之，正在研究淀粉样蛋白成像的临床用途，并且当前可获得的数据指向该成像技术的相关临床用途。