PET Software Enhances Diagnosis and Monitoring of Alzheimer's Disease

Alzheimer’s disease is marked by the buildup of beta-amyloid plaques and tau protein tangles in the brain. These deposits of beta-amyloid and tau appear in various brain regions at differing rates as the brain ages. Collectively, these pathological changes result in neurodegeneration, leading to cognitive and clinical deterioration in individuals affected by Alzheimer’s disease. The need for standardized measurements of beta-amyloid plaques via positron emission tomography (PET) has surged following the FDA's approval of new therapeutic drugs targeting Alzheimer's disease. These treatments aim to slow cognitive and functional decline in adults with mild cognitive impairment or mild dementia by eliminating beta-amyloid from the brain. Now, a software application with new features utilizes PET to measure these protein accumulations associated with Alzheimer's disease. Accurately quantifying the accumulation of amyloid plaques and tau proteins in the brains of Alzheimer’s patients can offer clinicians critical diagnostic and staging information pertaining to the disease.

Siemens Healthineers (Forchheim, Germany) has received CE Mark approval for two new features in its syngo.PET Cortical Analysis software. The first feature, Centiloid scoring, standardizes the measurement of brain amyloid plaques in PET scans across three commercially available beta-amyloid PET radiopharmaceuticals used in the diagnosis of Alzheimer’s disease. The second feature, tau PET quantification, evaluates and quantifies the distribution and density of tau protein tangles in the brain using images obtained with the radiopharmaceutical flortaucipir. The implementation of Centiloid scoring for beta-amyloid PET is significant for diagnosis, patient management, and the design of clinical trials focused on Alzheimer’s disease-modifying therapies. Siemens' new Centiloid scoring feature employs a 100-point scale to standardize beta-amyloid PET measurements, allowing clinicians to compare results across various PET scanners and tracers.

Image: syngo.PET Cortical Analysis software enables the measurement of beta-amyloid and tau protein deposits in the brain (Photo courtesy of Siemens Healthineers)

Moreover, tau deposits have been found to correlate closely with cognitive performance in individuals with Alzheimer’s disease. The new tau PET quantification feature from Siemens incorporates Braak staging, a six-stage model that classifies the progression of tau pathology in the brain and closely aligns with cognitive impairment levels, with advanced stages linked to more severe cognitive and clinical symptoms. Tau PET has played a vital role in recent amyloid-directed drug trials concerning patient stratification, drug management, and treatment response assessment. Given tau’s strong connection to disease severity, numerous investigational tau-targeted therapies are currently in different stages of clinical development, and tau PET quantification is expected to play a significant role in these trials.

“The addition of Centiloid scoring and tau PET quantification features to our syngo.PET Cortical Analysis software fortifies our integrated and comprehensive portfolio for detection, diagnosis, monitoring, and follow-up related to Alzheimer’s disease,” said Martin Cordell, PhD, director of product lifecycle management at Siemens Healthineers Molecular Imaging.

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