Combination Functional and Structural Imaging for the Diagnosis of Neurodegenerative Dementias – A Suggested Imaging Strategy


Early diagnosis of neurodegenerative dementia is challenging due to overlapping clinical and radiological features. With several potential disease-modifying therapies for Alzheimer’s disease (AD) currently in the late stages of development, an accurate diagnosis is now more important than ever. Structural and molecular imaging biomarkers including MRI, amyloid PET, 18F-FDG-PET, 123I-FP-CIT SPECT, and 123I-metaiodobenzylguanidine (123I-MIBG) increase diagnostic accuracy and aid clinical decision making but there is confusion as to how or when these biomarkers should be applied. The European Association of Nuclear Medicine (EANM). Focus 2 group provides a suggested framework as to how these imaging techniques can be applied and/or combined. They divide patients with cognitive impairment into three distinct groups based on their clinical presentation 1) suspected AD, 2) non-AD pathology suspected, and 3) cognitive decline in combination with Parkinsonian features. A recommended imaging strategy for each of these three groups is provided to increase diagnostic accuracy.

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Author: Prof. Killeen RP

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