CLINICAL NUCLEAR MEDICINE: CENTRAL NERVOUS SYSTEM (SPECT AND PET IMAGING)

Suspected cerebral infarction

Intracerebral hemorrhage

Carotid artery stenosis

Subarachnoid hemorrhage

Arterio-venous malformation (AVM)

Brain death

Subdural hematoma

Evaluation of dementia or personality change

CSF leaks and CSF shunts (Cistenography)

Investigation of seizures

Suspected intracerebral space-occupying lesions

Alzheimer's disease

Epilepsy

Parkinson's disease

Evaluation of dementia or personality change

CLINICAL APPLICATIONS/INDICATIONS

imaging agents

PRINCIPLE: Some _____ are capable of penetrating the intact blood-brain barrier.

brain

PRINCIPLE: After a radiopharmaceutical crosses the blood-brain barrier, it becomes trapped inside the ___.

regional perfusion

PRINCIPLE: The regional uptake and retention of the tracer are related to the ____

99mTc-DTPA (Diethylene Triamine Pentacaetic Acid

99mTc-GHA (glucoheptonate)

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING):

Primary and secondary brain tumors

Herpes encephalitis

Subdurals Carotid stenosis

AVMS

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING): INDICATIONS

- 99mTc-DTPA (Diethylene Triamine Pentacaetic Acid

- 99mTc-GHA (glucoheptonate)

99mTc-HMPAO (hexamethy|propyleneamine oxime

99mTc-ethylcysteinate diamer (ECD

CEREBRAL PERFUSION AGENTS:

Cerebral infarction and hemorrhage

Epilepsy

Dementia

Head trauma

CEREBRAL PERFUSION AGENTS: INDICATIONS

201TI (Thallium)

TUMOUR AGENTS:

Tumor recurrence versus fibrosis/ necrosis

TUMOUR AGENTS: INDICATIONS

111In-DTPA (lumbar puncture, the tracer will appear in the basal cisterns after about 2 hours)

CSF AGENTS

Dilated ventricles

CSF leaks

Shunt patency

CSF AGENTS INDICATIONS

123I-IBZM (iodobenzamide)

123I-epidepride

BRAIN NEUROTRANSMISSION

• Differential diagnosis of Parkinsonian syndromes

• Huntington's disease

• Pituitary adenoma

BRAIN NEUROTRANSMISSION INDICATIONS

20 mCi (740 MBq): 30 minutes- 1 hour

BRAIN NEUROTRANSMISSION

SCANNING: The adult dose is usually ___.Imaging begins ___ after injection

Tomographic images

BRAIN NEUROTRANSMISSION

SCANNING: ___ of the brain are obtained

18F-Fluoro-deoxyglucose (18F-FDG)

11C-Methionine

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING)

- Epilepsy. Preoperative evaluation in adults and in children.

- Dementia. Alzheimer's disease, front temporal dementia.

- Neurooncology. Differential diagnosis of cerebral space-occupying lesions, detection of viable tumor tissue (i.e., recurrence), and for noninvasive grading of tumors.

- HIV with cerebral pathology

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING) INDICATIONS

18F-Fluoro-deoxyglucose (18F-FDG)

11C-Methionine

Epilepsy

Preoperative evaluation in adults and in children.

Dementia

Alzheimer's disease, front temporal dementia

Neurooncology

Differential diagnosis of cerebral space-occupying lesions, detection of viable tumor tissue (i.e., recurrence), and for noninvasive grading of tumors.

95%

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING) PRINCIPLE: Glucose metabolism provides approximately ___ required for brain function.

neuronal activity

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING) PRINCIPLE: Glucose metabolism is closely related to ___

glucose metabolism

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING) PRINCIPLE: Changes in neuronal activity induced by various diseases are reflected as alteration of ____

18F-FDG

RADIOTRACERS/RADIOPHARMACEUTICALS (SPECT IMAGING) PRINCIPLE: ____ accumulation in neuronal tissue depends on the facilitated transport of glucose.