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Advances in the application of multi-tracer PET/MRI for AD diagnosis and immunotherapy monitoring
WU Xi  XU Xinru  ZHANG Xin  ZHANG Bing 

Cite this article as: WU X, XU X R, ZHANG X, et al. Advances in the application of multi-tracer PET/MRI for AD diagnosis and immunotherapy monitoring[J]. Chin J Magn Reson Imaging, 2026, 17(10): 164-172. DOI:10.12015/issn.1674-8034.2026.10.020.


[Abstract] Alzheimer's disease (AD) is the most common neurodegenerative disorder characterized by a complex pathophysiological process involving amyloid-β (Aβ) deposition, tau pathology, neurodegeneration, neuroinflammation, vascular injury, and synaptic dysfunction. With the expansion of ATX(N) diagnostic framework, the X dimension, comprising biomarkers of inflammation (I), vascular injury (V), and α-synucleinopathy (S), has been incorporated into the Aβ pathology (A), tau pathology (T), and neurodegeneration (N) framework, shifting AD diagnosis from single-pathology assessment toward multidimensional biological evaluation. Positron emission tomography/magnetic resonance imaging (PET/MRI), as an advanced imaging approach integrating molecular pathology with structural and functional alterations, plays a critical role in the early diagnosis, disease staging, and therapeutic monitoring of AD. This review summarizes the applications and clinical value of multi-tracer PET and multimodal MRI techniques in AD diagnosis and management within the ATX(N) framework, and further discusses the potential role of PET/MRI in monitoring disease-modifying therapies. The current limitations of PET/MRI research and future directions are also discussed, with the aim of providing a reference for precision diagnosis and treatment of AD and further development of multimodal imaging.
[Keywords] Alzheimer's disease；positron emission tomography；magnetic resonance imaging；radioactive tracer；diagnosis；treatment monitoring

WU Xi1, 2, 3   XU Xinru1, 2, 3   ZHANG Xin1, 2, 3   ZHANG Bing1, 2, 3*  

1 Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China

2 Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing 210008, China

3 Medical Imaging Center, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China

Corresponding author: ZHANG B, E-mail: zhangbing_nanjing@nju.edu.cn

Conflicts of interest   None.

Received  2026-07-23
Accepted  2026-09-24
DOI: 10.12015/issn.1674-8034.2026.10.020
Cite this article as: WU X, XU X R, ZHANG X, et al. Advances in the application of multi-tracer PET/MRI for AD diagnosis and immunotherapy monitoring[J]. Chin J Magn Reson Imaging, 2026, 17(10): 164-172. DOI:10.12015/issn.1674-8034.2026.10.020.

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