Traumatic Brain Injury: Nuclear Medicine Neuroimaging

Abstract

This chapter provides an up-to-date review of nuclear medicine neuroimaging in traumatic brain injury (TBI). 18F-FDG PET will remain a valuable tool in researching complex mechanisms associated with early metabolic dysfunction in TBI. Although evidence-based imaging studies are needed, 18F-FDG PET in the TBI acute phase appeared to be more useful in those patients in whom structural neuroimages fail to show abnormalities explaining their neurological state. 15O2-PET is also a solid technique for research in acute TBI, but in contrast to 18F-FDG PET it is not widely available due to its high cost. In the chronic TBI phase, most 18F-FDG PET studies converge to identify a diffuse cortical–subcortical hypometabolism involving key regions for cognitive function. Recent studies suggest the usefulness of 18F-FDG PET for the evaluation of therapeutic interventions in chronic TBI patients with cognitive deficits. In recent years, interest in studying cell-specific processes is growing. The use of radioligands as markers of neuroinflammation could become attractive for detecting secondary damage and serve for the evaluation of different therapeutic approaches. SPECT advances also make this technique a valid alternative for the study of TBI.