SPECT and PET of the Brain

Abstract

In this second edition, we update brain imaging in clinical nuclear medicine. In particular, we highlight recent developments in PET imaging of neurocognitive disorders. Alzheimer’s disease is pathologically characterized by accumulation of two abnormal proteins in the brain, namely, β-amyloid and hyperphosphorylated tau. Several PET radiopharmaceuticals for β-amyloid imaging have recently been approved for clinical use. In many clinical therapeutic trials, β-amyloid PET imaging has also been used to select subjects with β-amyloid pathologies in order to gauge the potential efficacy of anti-amyloid antibody therapies. In addition, several new PET radiopharmaceuticals for tau imaging are undergoing extensive developments, and tau PET imaging is now realistically following a similar path toward that of β-amyloid imaging in its clinical and research usefulness. Furthermore, PET imaging of neurotransmission systems has long been used as a valuable tool for the purpose of clinical diagnosis, research, and drug developments in movement disorders and other neuropsychiatric disorders. Other nuclear medicine brain imaging, such as [18]F-FDG-PET, remains of wide clinical and research use for the evaluation of brain tumors, cerebrovascular diseases, seizure disorders, and other neuropsychiatric diseases, although recent advances in the structural and functional MRI technology are increasingly recognized in the field of brain imaging.