From the Departments of Radiology.
Neurology, Mayo Clinic, Rochester, MN.
Clin Nucl Med. 2022 Sep 1;47(9):763-773. doi: 10.1097/RLU.0000000000004251. Epub 2022 May 12.
PET imaging plays an essential role in achieving earlier and more specific diagnoses of dementia syndromes, important for clinical prognostication and optimal medical management. This has become especially vital with the recent development of pathology-specific disease-modifying therapy for Alzheimer disease, which will continue to evolve and require methods to select appropriate treatment candidates. Techniques that began as research tools such as amyloid and tau PET have now entered clinical use, making nuclear medicine physicians and radiologists essential members of the care team. This review discusses recent changes in the understanding of dementia and examines the roles of nuclear medicine imaging in clinical practice. Within this framework, multiple cases will be shown to illustrate a systematic approach of FDG PET interpretation and integration of PET imaging of specific molecular pathology including dopamine transporters, amyloid, and tau. The approach presented here incorporates contemporary understanding of both common and uncommon dementia syndromes, intended as an updated practical guide to assist with the sophisticated interpretation of nuclear medicine examinations in the context of this rapidly and continually developing area of imaging.
PET 成像在实现痴呆综合征的早期和更特异性诊断方面发挥着重要作用，对临床预后和最佳医学管理至关重要。随着最近针对阿尔茨海默病的特定病理疾病修饰疗法的发展，这一点变得尤为重要，这种疗法将继续发展，并需要选择合适治疗候选者的方法。最初作为研究工具的技术，如淀粉样蛋白和 tau PET，现在已经进入临床应用，使核医学医师和放射科医生成为护理团队的重要成员。本综述讨论了对痴呆的理解的最新变化，并研究了核医学成像在临床实践中的作用。在此框架内，将展示多个病例来说明 FDG PET 解释的系统方法以及包括多巴胺转运体、淀粉样蛋白和 tau 在内的特定分子病理学的 PET 成像的整合。这里提出的方法结合了对常见和不常见痴呆综合征的当代理解，旨在作为更新的实用指南，帮助在这个快速和不断发展的成像领域中对核医学检查进行复杂的解释。
