Dedicated Brain PET in the Emerging Care Pathways of Alzheimer’s Disease

In the era of emerging blood-based biomarkers and continuously evolving diagnostic frameworks for Alzheimer’s disease (AD), dedicated brain positron emission tomography (PET) has re-emerged as a significant advancement in molecular neuroimaging and clinical practice. Compact, standalone brain PET systems are designed to overcome the economic and infrastructural limitations of conventional whole-body PET/CT scanners, offering reduced cost, smaller footprint, and increased accessibility without compromising diagnostic image quality. Leveraging advances in detector technology, silicon photomultipliers, and optimized correction and reconstruction algorithms, these systems achieve image performance that is clinically non-inferior for neurological applications.With the advent of disease modifying anti-amyloid therapies and the growing demand for biomarker-based early and differential diagnosis of AD, integration of dedicated brain PET into the new care pathways for diagnosis and disease management seems increasingly relevant.This review critically evaluates the clinical opportunities and challenges associated with the implementation of recently commercialized compact brain PET devices in the clinical practice, in alignment with current guideline-based biomarker strategies in early diagnosis and management of AD. Despite advantages such as smaller footprint, simplified operation, and cost-effectiveness, widespread adoption will require overcoming barriers including reimbursement models, clinical education, and harmonization of acquisition and quantification standards.Looking ahead, artificial intelligence holds promise to further streamline scanner operation, enable automated corrections, support dose optimization, and ensue standardized image interpretation across decentralized care settings.