Topçuoğlu Esen Saka, Akdemir Ümit Özgür, Atay Lütfiye Özlem
Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Turkey.
Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Turkey.
Noro Psikiyatr Ars. 2022 Dec 16;59(Suppl 1):S17-S23. doi: 10.29399/npa.28155. eCollection 2022.
Advances in the molecular biology, pathology and genetics of Alzheimer's disease (AD) and other degenerative dementias have led to the development of biomarkers specific to these diseases and radiotracers that are used in nuclear medicine. Imaging and non-imaging markers have enabled very early recognition of these diseases and have caused significant changes in their definitions. Amyloid positron emission tomography (PET) and tau PET, which are molecular imaging methods, [F18]fluorodeoxyglucose (FDG) PET showing the glucose metabolism pattern in the brain, dopamine transporter single photon emission computerized tomography (SPECT) that marks dopaminergic terminals are valuable tools for early recognition and differentiation of AD and its atypical variants, frontotemporal dementias and dementia with Lewy bodies. These imaging methods, which have different advantages over each other, have different indications for use and sometimes provide complementary information. In addition, research on radiotracers targeting neuroinflammation, astrocytes, synaptic density, and cholinergic terminals is ongoing. In this review, routinely used and newly developed nuclear imaging methods in AD and other neurodegenerative dementias, the agents used and their diagnostic features will be presented together with case examples.
阿尔茨海默病(AD)及其他退行性痴呆的分子生物学、病理学和遗传学进展,推动了针对这些疾病的生物标志物以及核医学中使用的放射性示踪剂的发展。成像和非成像标志物使得能够非常早期地识别这些疾病,并使其定义发生了重大变化。淀粉样蛋白正电子发射断层扫描(PET)和tau PET作为分子成像方法,[F18]氟脱氧葡萄糖(FDG)PET显示大脑中的葡萄糖代谢模式,标记多巴胺能终末的多巴胺转运体单光子发射计算机断层扫描(SPECT),是早期识别和区分AD及其非典型变体、额颞叶痴呆和路易体痴呆的有价值工具。这些成像方法彼此具有不同优势,有不同的使用指征,有时还能提供互补信息。此外,针对神经炎症、星形胶质细胞、突触密度和胆碱能终末的放射性示踪剂的研究也在进行中。在本综述中,将结合病例实例介绍AD和其他神经退行性痴呆中常规使用和新开发的核成像方法、所使用的试剂及其诊断特征。