Although clinical routine focuses on dichotomous and visual interpretation of amyloid PET, regional image assessment in research settings may yield additional opportunities. Understanding the regional-temporal evolution of amyloid pathology may enable earlier identification of subjects in the Alzheimer Disease pathologic continuum, as well as a finer-grained assessment of pathology beyond traditional dichotomous measures. This review summarizes current research in the detection of regional amyloid deposition patterns and its potential for staging amyloid pathology. Pathology studies, cross-sectional and longitudinal PET-only studies, and comparative PET and autopsy studies are included. Despite certain differences, cortical deposition generally precedes striatal pathology, and in PET-only studies, medial cortical regions are seen to accumulate amyloid earlier than lateral regions. Based on regional amyloid PET, multiple studies have developed and implemented models for staging amyloid pathology that could improve subject selection into secondary prevention trials and visual assessment in clinical routine.

中文翻译：

---

淀粉样蛋白病理学的时空顺序和PET成像的机会。

尽管临床常规研究侧重于淀粉样蛋白PET的二分法和视觉解释，但研究环境中的区域图像评估可能会带来更多机会。了解淀粉样蛋白病理学的时空演变可能使我们能够更早地确定阿尔茨海默病病理学连续性中的受试者，并且可以对传统的二分法进行更细粒度的病理学评估。这篇综述总结了当前在区域淀粉样蛋白沉积模式及其潜在的淀粉样蛋白病理学检测中的研究。包括病理学研究，仅横断面和纵断面PET研究以及比较性PET和尸检研究。尽管存在某些差异，但皮质沉积通常先于纹状体病理，在仅PET的研究中，观察到内侧皮质区域比外侧区域更早地积累淀粉样蛋白。基于局部淀粉样蛋白PET，多项研究已经开发和实施了用于评估淀粉样蛋白病理学的模型，这些模型可以改善受试者在临床常规研究中的二级预防试验和视觉评估的选择。