Universität zu Köln

Minoshima, Satoshi, Cross, Donna, Thientunyakit, Tanyaluck, Foster, Norman L. and Drzezga, Alexander (2022). F-18-FDG PET Imaging in Neurodegenerative Dementing Disorders: Insights into Subtype Classification, Emerging Disease Categories, and Mixed Dementia with Copathologies. J. Nucl. Med., 63. S. 2S - 13. RESTON: SOC NUCLEAR MEDICINE INC. ISSN 1535-5667

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Abstract

Since the invention of F-18-FDG as a neurochemical tracer in the 1970s, F-18-FDG PET has been used extensively for dementia research and clinical applications. FDG, a glucose analog, is transported into the brain via glucose transporters and metabolized in a concerted process involving astrocytes and neurons. Although the exact cellular mechanisms of glucose consumption are still under investigation, F-18-FDG PET can sensitively detect altered neuronal activity due to neurodegeneration. Various neurodegenerative disorders affect different areas of the brain, which can be depicted as altered F-18-FDG uptake by PET. The spatial patterns and severity of such changes can be reproducibly visualized by statistical mapping technology, which has become widely available in the clinic. The differentiation of 3 major neurodegenerative disorders by F-18-FDG PET, Alzheimer disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB), has become standard practice. As the nosology of FTD evolves, frontotemporal lobar degeneration, the umbrella term for pathology affecting the frontal and temporal lobes, has been sub-classified clinically into behavioral variant FTD; primary progressive aphasia with 3 subtypes, semantic, nonfluent, and logopenic variants; and movement disorders including progressive supranuclear palsy and corticobasal degeneration. Each of these subtypes is associated with differential F-18-FDG PET findings. The discovery of new pathologic markers and clinicopathologic correlations via larger autopsy series have led to newly recognized or redefined disease categories, such as limbic-predominant age-related TDP-43 encephalopathy, hippocampus sclerosis, primary age-related tauopathy, and argyrophilic grain disease, which have become a focus of investigations by molecular imaging. These findings need to be integrated into the modern interpretation of F-18-FDG PET. Recent pathologic investigations also have revealed a high prevalence, particularly in the elderly, of mixed dementia with overlapping and coexisting pathologies. The interpretation of F-18-FDG PET is evolving from a traditional dichotomous diagnosis of AD versus FTD (or DLB) to a determination of the most predominant underlying pathology that would best explain the patient's symptoms, for the purpose of care guidance. F-18-FDG PET is a relatively low cost and widely available imaging modality that can help assess various neurodegenerative disorders in a single test and remains the workhorse in clinical dementia evaluation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Minoshima, Satoshi UNSPECIFIED UNSPECIFIED UNSPECIFIED Cross, Donna UNSPECIFIED UNSPECIFIED UNSPECIFIED Thientunyakit, Tanyaluck UNSPECIFIED UNSPECIFIED UNSPECIFIED Foster, Norman L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Drzezga, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-685121
DOI:	10.2967/jnumed.121.263194
Journal or Publication Title:	J. Nucl. Med.
Volume:	63
Page Range:	S. 2S - 13
Date:	2022
Publisher:	SOC NUCLEAR MEDICINE INC
Place of Publication:	RESTON
ISSN:	1535-5667
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROGRESSIVE SUPRANUCLEAR PALSY; FRONTOTEMPORAL LOBAR DEGENERATION; POSTERIOR CINGULATE CORTEX; BRAIN ENERGY-METABOLISM; ALZHEIMERS-DISEASE; FDG-PET; DIFFERENTIAL-DIAGNOSIS; GLUCOSE-METABOLISM; HIPPOCAMPAL SCLEROSIS; ANATOMIC STANDARDIZATION Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68512