Assessing the state of Alzheimer’s imaging
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Assessing the state of Alzheimer’s imaging

por John R. Fischer, Staff Reporter | June 04, 2019
Molecular Imaging
From the June 2019 issue of HealthCare Business News magazine


“Until then, this issue creates another challenge to the field, in which being able to offer new imaging tools to a wider clinical population is hindered by the underestimated ‘value of knowing’ among payers,” said Barthel. “An accurate diagnosis is wrongfully not considered as a value of its own when it comes to reimbursement discussions.”

In addition to allowing patients and families to better plan for the onset of Alzheimer’s, using imaging to obtain an earlier diagnosis may support the development of effective treatments for the disease.

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“Most treatment trials likely start too late in the course of the disease,” said Dr. Matthias Brendel, a researcher in the department of nuclear medicine at Ludwig-Maximilians-University of Munich. “Brain function will probably not be restored by any therapy, as there is little potential at this stage for the neurons to recover; if the full-blown cascade is already running, it will be difficult to improve the outcome.”

Strong government restrictions related to the use of radiopharmaceuticals are another factor hindering new efforts to diagnose and treat the disease.

“These [restrictions] really hamper the use of molecular imaging in clinical trials and even led to exclusion of strongly regulated countries in some investigations,” said Brendel.

A better future for Alzheimer’s patients
“In my eyes, the most exciting imaging modality innovation in the last few years is the introduction of hybrid PET/MR,” said Barthel. “By that, it is now possible to image Alzheimer’s and other patients on a multimodality base in one session. This ‘one-stop shop’ imaging approach improves patient and caregiver convenience, and potentially also Alzheimer’s diagnosis itself.”

Medici, at Alzeca Biosciences, is also excited about the prospect of MR-based imaging and expects his imaging agents to be available by 2025. He believes their introduction, along with that of other imaging agents for MR, will significantly increase Alzheimer’s research and diagnoses at earlier stages.

Personalized medicine is an overarching trend in modern medicine, but the ability of nuclear medicine to find the best treatment for a specific patient falls in line perfectly with efforts to tackle Alzheimer’s.

“Molecular imaging could serve to stratify patients to their individualized ideal therapy,” said Brendel. “For treatments targeting neuroinflammation, it is probably necessary to analyze the current activation state of the innate immune system of the brain, as there is evidence that too low and too high response of the immune system to proteinopathies can damage the brain.”

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