Molecular neuroimaging in degenerative dementias.
In the context of the limitations of structural imaging, brain perfusion and metabolism using SPECT and PET have provided relevant information for the study of cognitive decline. The introduction of the radiotracers for cerebral amyloid imaging has changed the diagnostic strategy regarding Alzheimer's disease, which is currently considered to be a "continuum." According to this new paradigm, the increasing amyloid load would be associated to the preclinical phase and mild cognitive impairment. It has been possible to observe "in vivo" images using 11C-PIB and PET scans. The characteristics of the 11C-PIB image include specific high brain cortical area retention in the positive cases with typical distribution pattern and no retention in the negative cases. This, in combination with 18F-FDG PET, is the basis of molecular neuroimaging as a biomarker. At present, its prognostic value is being evaluated in longitudinal studies. 11C-PIB-PET has become the reference radiotracer to evaluate the presence of cerebral amyloid. However, its availability is limited due to the need for a nearby cyclotron. Therefore, 18F labeled radiotracers are being introduced. Our experience in the last two years with 11C-PIB, first in the research phase and then as being clinically applied, has shown the utility of the technique in the clinical field, either alone or in combination with FDG. Thus, amyloid image is a useful tool for the differential diagnosis of dementia and it is a potentially useful method for early diagnosis and evaluation of future treatments.
Servicio de Medicina Nuclear, Hospital "Marqués de Valdecilla", Universidad de Cantabria, Santander, España. jjimenez@humv.es
J F
JF
Jiménez Bonilla
J M
JM
Carril Carril
D016229:Amyloid beta-Peptides / Q000032:analysis; D000814:Aniline Compounds; D052160:Benzothiazoles; D001921:Brain / Q000000981:diagnostic imaging; D002250:Carbon Radioisotopes; D003704:Dementia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005026:Ethylene Glycols; D005462:Fluorine Radioisotopes; D005544:Forecasting; D057054:Molecular Imaging; D019636:Neurodegenerative Diseases / Q000000981:diagnostic imaging*; D016874:Neurofibrillary Tangles / Q000000981:diagnostic imaging; D059906:Neuroimaging / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013267:Stilbenes; D013844:Thiazoles; D015899:Tomography, Emission-Computed, Single-Photon; D016875:tau Proteins / Q000032:analysis
C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D016229:Amyloid beta-Peptides; D000814:Aniline Compounds; D052160:Benzothiazoles; D002250:Carbon Radioisotopes; D005026:Ethylene Glycols; D005462:Fluorine Radioisotopes; C054369:MAPT protein, human; D019275:Radiopharmaceuticals; D013267:Stilbenes; D013844:Thiazoles; D016875:tau Proteins; C581552:flutemetamol; C545186:florbetapir; C527756:4-(N-methylamino)-4'-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy)stilbene
(11)C-PIB; Alzheimer's disease; Amyloid imaging; Demencia; Dementia; Enfermedad de Alzheimer; Imagen de amiloide; Imagen molecular; Molecular imaging; Positron emission tomography; Tomografía de emisión de positrones