Imaging β-amyloid using [18F]flutemetamol positron emission tomography: from dosimetry to clinical diagnosis

In Alzheimer’s disease (AD), the deposition of β-amyloid (Aβ) is hypothesized to result in a series of secondary neurodegenerative processes, leading ultimately to synaptic dysfunction and neuronal loss. Since the advent of the first Aβ-specific positron emission tomography (PET) ligand, 11C-Pittsburgh compound B ([11C]PIB), several 18F ligands have been developed that circumvent the limitations of [11C]PIB tied to its short half-life. To date, three such compounds have been approved for clinical use by the US and European regulatory bodies, including [18F]AV-45 ([18F]florbetapir; Amyvid™), [18F]-BAY94-9172 ([18F]florbetaben; Neuraceq™) and [18F]3′-F-PIB ([18F]flutemetamol; Vizamyl™). The present review aims to summarize and discuss the currently available knowledge on [18F]flutemetamol PET. As the 18F analogue of [11C]PIB, [18F]flutemetamol may be of use in the differentiation of AD from related neurodegenerative disorders and may help with subject selection and measurement of target engagement in the context of clinical trials testing anti-amyloid therapeutics. We will also discuss its potential use in non-AD amyloidopathies.