How will imaging of dementia change?

Abstract

Disease–modifying agents for dementia have been clinically implemented in Japan. In order to select appropriate patients for treatment with disease–modifying drugs, it is necessary to estimate brain pathology more accurately than ever before. As is clear from many previous studies, the conventional clinical diagnosis of Alzheimer disease, which is based primarily on the evaluation of clinical symptoms, has a troubling misdiagnosis rate of more than 30%. In order to overcome this barrier of misdiagnosis, it is essential to evaluate brain pathology using a variety of biomarkers, and a good understanding of the significance and usefulness of various biomarkers as well as their limitations and pitfalls is required for clinicians involved in dementia treatment. In this article, this paper focus on imaging biomarkers in the evaluation of dementia pathophysiology, and summarize the current minimum requirements to be understood mainly in the diagnosis of brain pathophysiology. In addition, the potential problems that may arise in the future when amyloid PET imaging becomes widely used in clinical practice will be outlined.