The blood–brain barrier (BBB) is the interface between the central nervous system and systemic circulation. It tightly regulates what enters and is removed from the brain parenchyma and is fundamental in maintaining brain homeostasis. Increasingly, the BBB is recognised as having a significant role in numerous neurological disorders, ranging from acute disorders (traumatic brain injury, stroke, seizures) to chronic neurodegeneration (Alzheimer’s disease, vascular dementia, small vessel disease). Numerous approaches have been developed to study the BBB in vitro, in vivo, and ex vivo. The complex multicellular structure and effects of disease are difficult to recreate accurately in vitro, and functional aspects of the BBB cannot be easily studied ex vivo. As such, the value of in vivo methods to study the intact BBB cannot be overstated. This review discusses the structure and function of the BBB and how these are affected in diseases. It then discusses in depth several established and novel methods for imaging the BBB in vivo, with a focus on MRI, nuclear imaging, and high-resolution intravital fluorescence microscopy.
Original languageEnglish
Pages (from-to)1051-1083
Number of pages33
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number4
Early online date28 Nov 2022
Publication statusPublished - 1 Mar 2023


  • Alzheimer’s disease
  • BBB
  • Dementia
  • Imaging
  • MRI
  • Metabolic imaging
  • Neuroimaging
  • PET
  • Stroke


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