neuroimagingofdementia-theamericansocietyofneuroimaging.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * AD Biomarkers NIA-AA Criteria 2011 Brain A? amyloidosis PIB/florbetapir-PET ↓ CSF A?-42 Neuronal injury FDG-PET ↑ CSF-tau MRI atrophy Medial temporal lobes Paralimbic Temporoparietal cortex Imaging Findings in AD MRI Early: “Normal” or medial temporal atrophy Late: Generalized atrophy FDG PET Early: Hypometabolism in the temporal/parietal regions Late: Generalized hypometabolism with sparing of primary sensorimotor cortex Amyloid PET All stages: Generalized cortical amyloid deposition Amyloid binding may also occur with normal aging MRI and AD MRI and AD: Atrophy Coronal MRI can demonstrate progressive medial temporal and generalized atrophy in patients with AD Automated volumetric MRI analysis Hippocampal Volume Eval. NeuroQuant?, CorTechs Labs Commercially available Reported: Volumes of hippocampi HV and inferior lateral ventricle ILV Volumes as % of intracranial volume Normative %, based on age and gender Inferior Lateral Vent. Hippocampus Volumetric MRI Analysis- NeuroQuant? /products/neuroquant.php Volumetric MRI Analysis- NeuroQuant? /products/neuroquant.php Progressive Cognitive Decline T 0 years T 3 years T 8 years Progressive Cognitive Decline T 0 years T 3 years T 8 years P R I M A R Y P R O G R E S S I V E A P H A S I A “PET” and Dementia FDG PET Amyloid PET FDG PET in AD Profoundly diminished [18F]FDG uptake in the temporoparietal and parietal regions bilaterally arrows , seen on A axial and B parasagittal images From: Bertelson and Ajtai, 2014 Pittsburgh Compound-B PIB Radiolabeled thioflavin derivative [N-methyl- 11 C]2- 4’-methylaminophenyl -6-hydroxybenzothiazole Selectively binds to amyloid plaque and cerebrovascular amyloid Significant retention seen in: 90+% AD patients 60% patients with MCI 30% “normal” elderly Very short half life: 20 minutes Amyloid Imaging:Pittsburgh Compound-B PET Mathis J Med Chem 2003;46 13 Applied Neurology, Nov. 2005 suppl Mosc