Spect In Dementia

Single photon emission computerized tomography (SPECT) is a relatively cheap and widely available instrument for the examination of brain perfusion, cerebral blood flow and activity of neurotransmitter systems. The European project 'SPECT in dementia' sets out to overcome some of the factors holding back the development of clinical neuroimaging. It has developed a methodology for combining results from different imaging centres, at the same time making scan assessment more objective and powerful. Moreover, using objective voxel-based methods of image analysis improves the diagnostic performance of less-experienced clinicians and contributes to their training. This publication gives an excellent general overview of the new methods of image analysis and sharing. It is complemented by a systematic review of the diagnostic utility of SPECT in dementia and a cost-effectiveness model of diagnostic improvements in Alzheimers disease. This book is essential reading for all scientists, economists and clinicians in geriatric medicine, neurology and psychiatry, neuro-radiology and nuclear medicine working with patients suffering from dementia and Alzheimer's disease, who want to stay ahead in this rapid developing field.

PET and SPECT in Neurology highlight the combined expertise of renowned authors whose dedication to the investigation of neurological disorders through nuclear medicine technology has achieved international recognition. Classical neurodegenerative disorders are discussed as well as cerebrovascular disorders, brain tumors, epilepsy, head trauma, coma, sleeping disorders and inflammatory and infectious diseases of the CNS. The latest results in nuclear brain imaging are detailed. Most chapters are written jointly by a clinical neurologist and a nuclear medicine specialist to ensure a multidisciplinary approach. This state-of-the-art compendium will be valuable not only to neurologists and radiologists/nuclear medicine specialists but also to interested general practitioners and geriatricians. It is the second volume of a trilogy on PET and SPECT imaging in the neurosciences, the other volumes covering PET and SPECT in psychiatry and in neurobiological systems.

This Fourth Edition reflects the significant recent progress that has occurred in functional brain imaging, particularly the increased use of PET/SPECT, the use of SPECT and PET in movement disorders and dementia, and advances in radiopharmaceutical development and instrumentation. Chapter topics include PET physics and instrumentation, PET radiopharmaceuticals, SPECT radiopharmaceuticals, and technical factors. The entire book has been thoroughly revised to reflect an appropriate balance between SPECT and PET applications. Highlights of this edition include a new chapter on neuroreceptor imaging and kinetic modeling, a new chapter on brain imaging in movement disorders, and significant updates on SPECT radiopharmaceuticals.

This up-to-date, superbly illustrated book is a practical guide to the effective use of neuroimaging in the patient with cognitive decline. It sets out the key clinical and imaging features of the various causes of dementia and directs the reader from clinical presentation to neuroimaging and on to an accurate diagnosis whenever possible. After an introductory chapter on the clinical background, the available "toolbox" of structural and functional neuroimaging techniques is reviewed in detail, including CT, MRI and advanced MR techniques, SPECT and PET, and image analysis methods. The imaging findings in normal ageing are then discussed, followed by a series of chapters that carefully present and analyze the key findings in patients with dementias. Throughout, a practical approach is adopted, geared specifically to the needs of clinicians (neurologists, radiologists, psychiatrists, geriatricians) working in the field of dementia, for whom this book will prove an invaluable resource.

In the developed world, images of brain structure are available as an everyday diagnostic aid, and the characteristic appearances of most pathological conditions can be looked up in a textbook. Functional brain imaging is to this day less widely used, partly because most pressing diagnostic questions can be answered by refer ence to the patient's cerebral anatomy, partly for reasons of technical limitations of functional techniques. PET as a technique is sufficiently resource-demanding and complex to inhibit its use as an everyday diagnostic technique. SPECT lacked suitable tracers for many years, and early systems had poor spatial resolution. However, rotating gamma camera technology has advanced to the point where images of the brain of reasonable quality can be obtained at most large hospitals, and practical tracers, particularly of regional cerebral blood flow, are easily avail able. As research advances, clinical applications are emerging. A recent report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology! details a number of currently recognised clinical appli cations, some of which are dealt with in this book. Given this recognition, it is increasingly important that clinicians (particularly neuroclinicians, psychiatrists and specialists in cerebrovascular disease), nuclear medicine specialists and physicists acquire an idea of the major applications of the technique, and the research background on which these applications are based.

Among all the clinical indications for which radiologists, nuclear medicine phy- cians, neurologists, neurosurgeons, psychiatrists (and others examining disorders of the brain) order and read brain PET scans, demand is greatest for those pertaining to dementia and related disorders. This demand is driven by the sheer prevalence of those conditions, coupled with the fact that the differential diagnosis for causes of cognitive impairment is wide and often difficult to distinguish clinically. The conceptual framework by which evaluation and management of dementia is guided has evolved considerably during the last decade. Although we still are far from having ideal tests or dramatic cures for any of the established causes of dementia, our options have expanded with respect to both the diagnostic and the- peutic tools now available. In the first chapter of this book, the contribution and limitations of different elements of the clinical examination for diagnosis of cog- tive symptoms are described, and the roles of structural and functional neuroim- ing in the clinical workup are given context.