Brain PET imaging is taking on a more practical role in the care of people being considered for newer Alzheimer’s medicines. At the European Association of Nuclear Medicine’s 2026 congress in Vienna, specialists are set to discuss early routine-use experience with amyloid and tau PET scans, which can reveal biological changes associated with the disease and help clinicians tailor treatment decisions.
The shift matters because anti-amyloid monoclonal antibodies are intended for Alzheimer’s disease, not every form of dementia. Dementia affects an estimated 57 million people worldwide, according to the World Health Organization, and Alzheimer’s accounts for roughly 60% to 70% of cases. Establishing the underlying pathology is therefore central to deciding whether a person is a plausible candidate for a targeted therapy.
Confirming amyloid pathology before treatment
Amyloid PET scans use targeted tracers to visualize amyloid deposits in the brain. Matthias Brendel, deputy director of the Department of Nuclear Medicine at LMU Munich, said the scans can help determine whether a person with dementia has Alzheimer’s disease or another form of dementia.
That distinction has become more consequential with the arrival of beta-amyloid-targeting antibodies including lecanemab and donanemab. The source material notes that the FDA and European Commission have approved these drugs in recent years, and that they can only be effective when Alzheimer’s disease is present.
Clinicians can also use blood biomarkers and cerebrospinal-fluid testing to support a diagnosis. But Brendel said those tests can leave uncertainty in some cases, and he recommends amyloid PET imaging to confirm amyloid pathology before treatment begins. In that framing, the scan is not simply an additional image: it is a way to match a biological diagnosis with a therapy designed around that biology.
Imaging for precision medicine
PET is part of a broader nuclear-medicine approach in which targeted tracers make functions and biological targets visible. Brendel described molecular imaging as important for precision medicine because it allows clinicians to characterize disease and tailor care to an individual patient.
For Alzheimer’s disease, the approach separates two related but distinct questions. One is whether amyloid pathology is present and whether an anti-amyloid medicine is appropriate. The other is how far the disease may have progressed and what that could mean for prognosis. Tau PET imaging can add information on progression and prognosis, complementing amyloid imaging rather than replacing it.
This distinction is significant because dementia symptoms alone do not establish the precise biological process occurring in the brain. Imaging can give physicians a direct view of a disease-associated target, helping place treatment decisions on evidence more specific than symptoms alone.
Monitoring becomes part of the discussion
The EANM meeting will also examine therapeutic monitoring. Amyloid PET may help show how treatment is working, while tau PET provides additional context about disease progression. The source does not present PET as a standalone answer for every patient or every clinical question. Instead, it describes a growing role alongside other diagnostic tools and clinical judgment.
That practical integration is likely to be the central issue as anti-amyloid medicines move further into clinical care. A treatment pathway needs a way to identify people whose disease biology aligns with the medicine, assess the individual case before therapy, and follow the condition over time. PET imaging is increasingly being considered across those stages.
What the Vienna discussions signal
The congress, running from October 17 to 21, is positioned as a forum for experts to share first experience with amyloid and tau PET in routine clinical use. That emphasis reflects a transition from discussing molecular imaging mainly as a research capability to evaluating how it fits into real treatment decisions.
The immediate message is measured: PET imaging can help confirm the presence of amyloid pathology, support decisions around anti-amyloid drugs, and provide information on progression and prognosis. Its expanding use reflects the increasingly specific nature of Alzheimer’s treatment, where determining the biology behind a person’s dementia is an essential step before selecting a targeted medicine.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
