Home › Research › Biomarkers
Imaging and Fluid Biomarkers of Alzheimer Disease: Complementation Rather Than Competition
Drzezga A, Barthel H.. Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2025-06-06
Topic: Amyloid, tau and blood-test diagnosis
With the introduction of the new causal amyloid targeting therapies, the role of biomarker-assisted diagnosis of Alzheimer disease (AD) has received a further boost. In addition to the well-established gold standard, amyloid PET imaging, cerebrospinal fluid diagnostics are currently being suggested for therapy inclusion and patient selection. In addition, new types of blood-based biomarkers are being introduced, holding diagnostic potential together with potentially easy and broad accessibility in the future. In addition to the introduction of new biomarkers and new therapeutic approaches, the guidelines for biomarker-based classification of AD are also in flux, sometimes clustering biomarker classes and neglecting their individual characteristics, leading to divergent or controversial discussions. It is difficult to keep pace with these rapid developments, and the respective roles of the various AD biomarkers have not yet been clearly defined. Thus, in this paper, we attempt to discuss the strengths and weaknesses of the various imaging and fluid biomarkers of AD and classify what we consider to be their complementary, nonredundant value for various diagnostic questions. We propose an integrated biomarker algorithm for the purpose of reliable AD patient selection for amyloid targeting therapies.
Key findings
- In addition, new types of blood-based biomarkers are being introduced, holding diagnostic potential together with potentially easy and broad accessibility in the future.
- In addition to the introduction of new biomarkers and new therapeutic approaches, the guidelines for biomarker-based classification of AD are also in flux, sometimes clustering biomarker classes and neglecting their individual characteristics, leading to divergent or controversial discussions.
- It is difficult to keep pace with these rapid developments, and the respective roles of the various AD biomarkers have not yet been clearly defined.
- Thus, in this paper, we attempt to discuss the strengths and weaknesses of the various imaging and fluid biomarkers of AD and classify what we consider to be their complementary, nonredundant value for various diagnostic questions.
- We propose an integrated biomarker algorithm for the purpose of reliable AD patient selection for amyloid targeting therapies.
Why it matters
This paper discusses the strengths and weaknesses of imaging and fluid biomarkers and proposes an integrated algorithm for selecting patients for amyloid-targeting therapies. It is a commentary on biomarker use and does not itself treat, cure, or prevent Alzheimer's disease.
New to this subject? Start with our plain-English guide: Blood tests & biomarkers →
Study details
- Evidence strengthLow
How this study scored 43/100
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 (Journal of nuclear medicine : official publication, Society of Nuclear Medicine) |
| Journal's citation record | 2 / 4 | Journal of Nuclear Medicine: journal h-index 230 (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 | 4 / 5 | 2025 — within 3 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 | 5.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 9.5× 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 | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Henryk Barthel: h-index 66 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Cologne: institution h-index 879 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40480828) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.2967/jnumed.125.270152
- PubMed: 40480828
- Original source →
- Free full text: jnm.snmjournals.org →
Full text: free to read — Unpaywall lists this copy as free to read: the link above (checked 10 Oct 2026).
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
Drzezga, A., & Barthel, H. (2025). Imaging and Fluid Biomarkers of Alzheimer Disease: Complementation Rather Than Competition. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. https://doi.org/10.2967/jnumed.125.270152
Vancouver
Drzezga A, Barthel H. Imaging and Fluid Biomarkers of Alzheimer Disease: Complementation Rather Than Competition. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2025. doi:10.2967/jnumed.125.270152. PMID: 40480828.
BibTeX
@article{drzezga2025-40480828,
author = {Drzezga, A. and Barthel, H.},
title = {{Imaging and Fluid Biomarkers of Alzheimer Disease: Complementation Rather Than Competition}},
journal = {Journal of nuclear medicine : official publication, Society of Nuclear Medicine},
year = {2025},
doi = {10.2967/jnumed.125.270152},
pmid = {40480828},
url = {https://doi.org/10.2967/jnumed.125.270152}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 37.
Related studies in Biomarkers
Also tagged “biomarkers”
821 studies in the library carry the topic tag “biomarkers”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 821 tagged studies.