Current use and perspectives of PET imaging in Alzheimer's disease: A Spanish national survey

Background Novel therapies for Alzheimer's disease are expected to increase the demand for biomarkers. PET will likely play a central role in patient selection and treatment monitoring, requiring adequate infrastructure and trained professionals. Objective To assess the current status of Nuclear Medicine departments in Spain regarding organization, expertise, and available infrastructure. Methods We conducted a nationwide survey among Nuclear Medicine departments in Spain. Results Respondents averaged 19.8 years of professional experience; 62.0% had specific neuroimaging training and 76.0% reported high confidence in amyloid PET interpretation. Hospitals were mainly public (70.6%) and widely distributed geographically, and 73.0% reported having cognitive impairment units. Following the INVEAT plan, Spain currently has 147 PET scanners, although capacity varies: most centers operate one scanner and five reported having none. Amyloid PET is available in 77.0% of departments, with annual volumes ranging from fewer than 10 to more than 100 studies; 15.0% cannot perform amyloid PET due to regional limitations. Quantification tools are available in 41.3% of centers, although only 15.5% include quantitative metrics in reports, while 66.7% support the use of centiloid standardization. Nearly all respondents anticipate increased indications for amyloid PET (screening 83.7%; monitoring 68.5%) and support multidisciplinary collaboration (89.1% favor Neuroimaging Committees). About half report workforce needs, mainly nuclear medicine physicians (46.2%). Research activity in Alzheimer's disease is expected to increase (95.6%). Conclusions Most departments recognize the key role of amyloid PET for anti-amyloid therapy implementation and anticipate increased demand, highlighting the need to expand availability, implement quantification tools, and strengthen multidisciplinary collaboration.