Amyloid PET and Tau PET in the Era of Anti-Amyloid Antibody Therapies for Alzheimer’s Disease

Abstract

In the clinical management of Alzheimer’s disease (AD), amyloid PET and tau PET have become increasingly important as non-invasive imaging biomarkers capable of visualizing core AD pathological features in vivo. With the advent of anti-amyloid 𝛽 monoclonal antibodies such as lecanemab and donanemab, amyloid PET now plays a pivotal role in determining treatment eligibility and monitoring therapeutic response. Tau PET, which reflects the extent and progression of neurofibrillary tangle pathology, provides complementary information regarding disease staging and prognosis. These imaging modalities, aligned with the ATN classification framework, support more accurate diagnosis and individualized treatment planning. Furthermore, recent technological advances―including high-resolution, dedicated brain PET scanners and artificial intelligence (AI)-based image analysis―have significantly improved diagnostic precision and clinical applicability. These developments not only facilitate the detection of early pathological changes but also enhance reproducibility and scalability in both research and routine practice. As disease-modifying therapies continue to emerge, the integration of amyloid and tau PET imaging is expected to be central to the early diagnosis, patient stratification, and personalized therapeutic interventions for AD. This review highlights the evolving clinical roles of amyloid and tau PET in the new era of targeted AD treatment.