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FDG PET (and MRI) for Monitoring Immunotherapy in Alzheimer Disease
Høilund-Carlsen PF, Revheim ME, Alavi A, Barrio JR.. Clinical nuclear medicine, 2023-05-23
Topic: Amyloid, tau and blood-test diagnosis
Abstract Passive immunotherapy for Alzheimer disease has been tried for over 10 years without success. However, in 2021 and most recently in January 2023, the US Food and Drug Administration granted accelerated approval of 2 antibodies for this purpose, aducanumab and lecanemab. In both cases, the approval was based on a presumed therapy-related removal of amyloid deposits from the brain and, in the case of lecanemab, also some delay in cognitive decline. We question the validity of the evidence for the removal of amyloid in particular as assessed by amyloid PET imaging, believing that what is observed is more likely a large nonspecific amyloid PET signal in the white matter that diminishes during immunotherapy-in line with dose-dependent increases in amyloid-related imaging abnormalities and increased loss of cerebral volume in treated compared with placebo patients. To investigate this further, we recommend repeat FDG PET and MRI in all future immunotherapy trials.
Key findings
- We question the validity of the evidence for the removal of amyloid in particular as assessed by amyloid PET imaging, believing that what is observed is more likely a large nonspecific amyloid PET signal in the white matter that diminishes during immunotherapy-in line with dose-dependent increases in amyloid-related imaging abnormalities and increased loss of cerebral volume in treated compared with placebo patients.
Why it matters
The authors question whether amyloid PET evidence of amyloid removal during immunotherapy is valid, suggesting the signal may instead come from nonspecific white matter changes. They recommend repeat FDG PET and MRI in future immunotherapy trials, and this is a commentary rather than a study of treatment benefit.
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Study details
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Clinical nuclear medicine) |
| Journal's citation record | 1 / 4 | Clinical Nuclear Medicine: journal h-index 90 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 15 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.0 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 2 / 6 | Cited 2.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 11 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Jorge R. Barrio: h-index 71 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, Los Angeles: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37314733) |
| Free to read | 2 / 2 | Free to read |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1097/rlu.0000000000004710
- PubMed: 37314733
- Original source →
- Free full text: Clinical Nuclear Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Høilund-Carlsen, P. F., Revheim, M. E., Alavi, A., & Barrio, JR. (2023). FDG PET (and MRI) for Monitoring Immunotherapy in Alzheimer Disease. Clinical nuclear medicine. https://doi.org/10.1097/rlu.0000000000004710
Vancouver
Høilund-Carlsen PF, Revheim ME, Alavi A, Barrio JR. FDG PET (and MRI) for Monitoring Immunotherapy in Alzheimer Disease. Clinical nuclear medicine. 2023. doi:10.1097/rlu.0000000000004710. PMID: 37314733.
BibTeX
@article{hoilundcarlsen2023-37314733,
author = {Høilund-Carlsen, P. F. and Revheim, M. E. and Alavi, A. and Barrio, JR.},
title = {{FDG PET (and MRI) for Monitoring Immunotherapy in Alzheimer Disease}},
journal = {Clinical nuclear medicine},
year = {2023},
doi = {10.1097/rlu.0000000000004710},
pmid = {37314733},
url = {https://doi.org/10.1097/rlu.0000000000004710}
}
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