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Perfusion SPECT and FDG-PET

Published online by Cambridge University Press:  10 June 2011

Karl Herholz
Karl Herholz*
Affiliation:
Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
*
Correspondence should be addressed to: Karl Herholz, MD, FRCP, Professor in Clinical Neuroscience, Wolfson Molecular Imaging Centre, University of Manchester, 27 Palatine Road, Manchester M20 3LJ, UK. Phone: +44 161-275-0014; Fax: +44 161-275-0003. Email: karl.herholz@manchester.ac.uk.
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Abstract

Both perfusion SPECT and FDG-PET provide images that closely reflect neuronal activity. There is a characteristic regional impairment in Alzheimer's disease (AD) that involves mainly the temporo-parietal association cortices, mesial temporal structures and to a more variable degree also the frontal association cortex. This pattern of functional impairment can provide a biomarker for diagnosis of AD and other neurodegenerative dementias at the clinical stage of mild cognitive impairment, and for monitoring of progression. FDG-PET is quantitatively more accurate and thus better suited to multicenter studies than perfusion SPECT. Regional metabolic and blood flow changes are closely related to clinical symptoms, and most areas involved in these changes will also develop significant cortical atrophy. FDG-PET is complementary to amyloid PET, which targets a molecular marker that does not have a close relation to current symptoms. Current restrictions in the availability and cost of FDG-PET are being reduced, as oncological FDG-PET is being adopted as a standard clinical service in most countries. Limitations in the availability of trained staff should be overcome by training programs set up by professional organizations. Against the background of the development of new criteria for diagnosing AD before the onset of dementia, FDG-PET is expected to play an increasing role in diagnosing patients at an early stage of AD and in clinical trials of drugs aimed at preventing or delaying the onset of dementia.

Keywords

PETSPECTperfusionglucose metabolismdementiaAlzheimer's diseaseclinical trials
Type
Review Article
Information
International Psychogeriatrics , Volume 23 , Supplement S2: Clinical use of neuroimaging in dementia: an international perspective , September 2011 , pp. S25 - S31
Copyright
Copyright © International Psychogeriatric Association 2011

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