Clinical amyloid and tau positron emission tomography imaging in Alzheimer's disease: image interpretation in the era of anti-amyloid therapies.

PURPOSE OF REVIEW: The introduction of disease-modifying anti-amyloid therapies has shifted the role of positron emission tomography (PET) imaging in Alzheimer's disease from confirming diagnosis to actively guiding clinical decision-making within the AT(N) framework.

RECENT FINDINGS: Amyloid PET has become central for confirming treatment eligibility, quantifying biological response, and supporting PET-guided strategies for treatment duration, particularly through standardized visual interpretation and Centiloid-based quantification. Tau PET provides complementary information by reflecting disease stage and the burden of pathology most closely associated with cognitive impairment, thereby helping to contextualize expected clinical benefit. Recent clinical trials have integrated PET imaging to monitor therapeutic effects and to support translation into routine clinical practice.

SUMMARY: This review focuses on practical aspects of visual interpretation and semi-quantitative analysis of amyloid and tau PET, discusses tracer-specific considerations and ongoing harmonization efforts, and summarizes the expanding clinical role of PET imaging. Together, amyloid and tau PET support a more biologically grounded and individualized approach to Alzheimer's disease care in the era of disease-modifying therapies.