title: Nuclear medicine diagnostic techniques in the era of pathophysiology-based CSF biomarkers for Alzheimer's disease.
abstract: Nuclear medicine techniques were the first functional imaging techniques used to support the clinical diagnosis of Alzheimer's Disease (AD). Perfusion-SPECT allows registration of regional cerebral blood flow (rCBF) which is altered in a characteristic temporal-parietal pattern in AD. Numerous studies have shown the diagnostic value of reduced CBF and metabolic changes using perfusion-SPECT and FDG-PET in AD diagnosis as well as in differential diagnosis against frontotemporal dementia (FTD), dementia with Lewy-Bodies (DLB), and vascular cognitive disorders. This renders perfusion-SPECT an important piece of the puzzle (together with other diagnostic tests) by the clinician is often faced when making a final etiologic dementia diagnosis especially between AD and FTD. A similar diagnostic value can be expected when arterial spin labeling (ASL) MRI sequence is used, but the diagnostic value has yet to be confirmed in lager studies. Recently, more pathophysiology-based biomarkers in CSF and Amyloid-PET tracers have been developed that probably have a higher diagnostic accuracy than the more indirect rCBF changes seen in perfusion-SPECT. In the current review, we describe recent advances in AD biomarkers as well as improvements in the SPECT technique.
authors.affiliation: Department for Psychiatry and Psychiatry, University of Erlangen-Nurenberg, Erlangen, Germany. markus.weih@uk-erlangen.de
authors.forename: Markus
authors.initials: M
authors.lastname: Weih
authors.forename: Umüt
authors.initials: U
authors.lastname: Degirmenci
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kreil
authors.forename: Gerald
authors.initials: G
authors.lastname: Suttner
authors.forename: Daniela
authors.initials: D
authors.lastname: Schmidt
authors.forename: Johannes
authors.initials: J
authors.lastname: Kornhuber
authors.forename: Piotr
authors.initials: P
authors.lastname: Lewczuk
authors.forename: Torsten
authors.initials: T
authors.lastname: Kuwert
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D001921:Brain / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D006801:Humans; D008279:Magnetic Resonance Imaging; D009683:Nuclear Medicine / Q000379:methods* / Q000639:trends*; D049268:Positron-Emission Tomography / Q000379:methods / Q000639:trends; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000639:trends
chemical_list: D015415:Biomarkers; D019275:Radiopharmaceuticals