Ruolo della diagnostica SPET e PET · Baseline cognitive scores (A), regional 18F-FDG uptake (B),...

Ruolo della diagnostica SPET e PET

Elena CraccoServizio di Medicina Nucleare

Ospedale dellrsquoAngelo Mestre (Ve)

LE DEMENZE SINERGIE TRA OSPEDALE E TERRITORIOMAPPA DEI SERVIZI DELLA REGIONE VENETOMirano 5 ottobre 2019

1

bull Imaging funzionale delle demenze

bull FDG-PET patterns di diagnosi differenzialebull Alzheimer Disease

bull Fronto-Temporal Dementia

bull Lewy Body Dementia

bull Datscan SPET

bull PET con tracciante per amiloide indicazioni

bull Utilitagrave clinica della dgn nel paziente con MCI

2

Sommario





bull Datscan SPET


3

Sommario

Aβ-amyloid α-sinucleino-pathies tau-pathies

Alzheimer

Lewy-body

MixedVascular

Large-vesselsSmall-vessels

Ischemic-hypoperf

Hemorragic

Fronto-temporal

Frontal degeneration

Non fluent aphasia

PSPCBD

ALS-FTD Complex

Semantic dementia

PDD

Ischemia 4

Main dementias

Malattie complesse (geni+ambiente)

Eterogeneitagrave variabilitagrave (esordio-durata- evoluzione)

Overlapping sintomatologico

Diagnosi complessa e comunque probabilistica (100 solo autoptica)

5

Demenze diagnosi clinica

6

Multimodal differential diagnosis of dementias

MRI ΒETA AMILOIDE18F-Flutemetamolo

METABOLISMO GLU18F-FDG

DOPAMINA123 FP-CIT

7

Evolution of neuroimaging in AD

8

Brain energy metabolism

Magistretti et al Am J Cl Nutr 2009

9

Functional imaging

Petersen et al Nature 1988

Functional imaging

10

Functional imaging

Rodriguez-Vieitez E et al Methods Biol Mol 2018Imaging Neuroinflammation Quantification of Astrocytosis in a Multitracer PET Approach

11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014

Parietal-temporalPosterior cingulatePrecuneusMedial temporal lobe

18FDG-PET Characteristic patterns of AD

13

Surface-rendered image shows FDG hypometabolism in the posterior cingulate and precuneus cortices Blue = minus2 SDs purple = minus3 SDs The cingulate gyrus and precuneus are important structures to identify and analyze when reviewing brain FDG PET images obtained in patients with cognitive impairment Minoshima 2014

14


Minoshima 2014

Posterior corticalhypometabolism of AD

+

involvement of the lateral occipitalassociation cortex

Posterior cerebral atrophy (PCA)

15

16

Window for AD prevention

Sasaguri H et al EMBO 2017 Golde et al 2011

Ewers M et al Neurology 2013Cognitive reserve associated with FDG-PET in preclinical Alzheimer disease

Pre-dementia stage

17

18

MCI Differential Diagnosis AD vs FTD

Caminiti SP et al Neuroimage Clin 2018FDG-PET and CSF biomarker accuracy in prediction of conversion to different dementias in a large multicentre MCI cohort

19

Maggior fonte di errore ipometabolismo temporo-parietale

Womack et al Arch Neurol 2010

Differential diagnosis AD vs FTD

Minoshima 2014

Characteristic metabolic patterns of FTD

20

FrontalAnterior temporalAnterior cingulate

Relatively preservedPCC precuneus

Classic FTD

Frontal predominant form

Temporal variant SD

disinhibited behavior and impaired language

disinhibited behavior

impaired language

Fronto-Temporal Dementia Variants

Minoshima 2014


21

22


23

18FDG-PET bv FTD

Franceschi et al Ann Neurol 2005

18FDG-PET bv FTD

24

Brocarsquos area hypometabolismBrocarsquos area hypometabolism PNFA

Nestor PJ et al 2003

Asimmetry LEFT LOBE

Inferior frontal gyrusInferior temporal lobeAnterior insula

25

International consensus criteria for bv FTD

Rascovsky et al Brain 2011

Minoshima 2014

Ventrolaterale frontaleParietal-temporalPrecuneusOccipitalVisual cortex

Characteristic Metabolic patterns of LBD

26

27

Ratio PCCprecuneus + cuneus

18FDG-PET Cingulate Island Sign (CIS)

Lim SM et al JNM 2009

Attenzione

egrave presente anche nella PDD e PCA

18 FDG-PET differential diagnosis of dementias

28

29

30

31





bull Datscan e MIBG SPET


32

Sommario

33

L-TYROSINE

L-DOPA

DA

123I-Ioflupane (Datscan) LBD

E consigliato luso della PET con 18F-FDG

nella diagnosi precoce dellAD e nella dd tra AD e VD e tra AD e FTD

34

E consigliato luso della SPECT con 123I-FP-CIT

nella dd tra AD e LBD

FDG-PET e Datscan-SPET Indicazioni

Morbelli et al ELNMI 2015

34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39

Perani D et al Biomed Res Int 2014

A Survey of FDG- and Amyloid-PET Imaging in Dementia and GRADE Analysis

Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812

Temporal Lateral R 969

Temporal lateral R 992

Precuneus PostCing R 869

Precuneus PostCing L 781

40

Paziente con sdr extrapiramidaledeficit cognitivi

DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA

P IATROGENOTEADSWEDD

MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET

PD LBD PSP CBD MSA AD FTD

42

Utilizzo clinico dei traccianti PET per amiloide

43

44




DOPAMINA123 FP-CIT

45

J Alzheimers Dis Rep 2019 3(1) 95ndash102 Mild Cognitive Impairment with a High Risk of Progression to Alzheimerrsquos Disease Dementia (MCI-HR-AD) Effect of Souvenaidreg Treatment on Cognition and 18F-FDG PET Scans2019 Apr 29

46

Baseline cognitive scores (A) regional 18F-FDG uptake (B) and MRI-based HV hippocampal volumeand CGM (C) in MCI-to-AD dementia converters (blue) versus non-converters (black) after 1 year follow-up

Neuroimage Clin Mar 2019Association of short-term cognitive decline and MCI-to-AD dementia conversion with CSF MRI amy and 18F-FDG-PET imagingJulie Ottoy et al

1 La diagnosi di demenza egrave eminentemente clinica

2 La 18FDG-PET presenta patterns caratteristici e precoci che nella maggior parte dei casi differenziano con sufficiente sensibilitagrave e specificitagrave AD VD FTD LBD

3 La 123I-Datscan-SPET ha altissima specificitagrave nella dd tra AD e LBD

4 La PET con traccianti per amiloide ha un alto VPN dovrebbe essere usata solo in alcune categorie di pazienti e solo se la dgn rimane incerta dopoFDG-PET eo Datscan-SPET

47

Conclusioni

48

Grazie

Se riuscire a dimenticare egrave segno di sanitagrave mentale

Ricordare senza posa egrave ossessione e follia

Jack London





bull Datscan SPET


bull Utilitagrave clinica della dgn nel paziente con MCI

2

Sommario





bull Datscan SPET


3

Sommario


Alzheimer

Lewy-body

MixedVascular


Ischemic-hypoperf

Hemorragic

Fronto-temporal


Non fluent aphasia

PSPCBD

ALS-FTD Complex

Semantic dementia

PDD

Ischemia 4

Main dementias





5


6




DOPAMINA123 FP-CIT

7


8



9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London





bull Datscan SPET


3

Sommario


Alzheimer

Lewy-body

MixedVascular


Ischemic-hypoperf

Hemorragic

Fronto-temporal


Non fluent aphasia

PSPCBD

ALS-FTD Complex

Semantic dementia

PDD

Ischemia 4

Main dementias





5


6




DOPAMINA123 FP-CIT

7


8



9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London


Alzheimer

Lewy-body

MixedVascular


Ischemic-hypoperf

Hemorragic

Fronto-temporal


Non fluent aphasia

PSPCBD

ALS-FTD Complex

Semantic dementia

PDD

Ischemia 4

Main dementias





5


6




DOPAMINA123 FP-CIT

7


8



9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London





5


6




DOPAMINA123 FP-CIT

7


8



9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

6




DOPAMINA123 FP-CIT

7


8



9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

7


8



9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

8



9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

9

Functional imaging


Functional imaging

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

10

Functional imaging


11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

11

Biomarkers





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London





bull Datscan SPET


12

Sommario

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Minoshima 2014



13


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London


14


Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Minoshima 2014


+



15

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

16




Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London


Pre-dementia stage

17

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

18



19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

19




Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Minoshima 2014


20



Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Classic FTD


Temporal variant SD



impaired language


Minoshima 2014


21

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

22


23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

23

18FDG-PET bv FTD


18FDG-PET bv FTD

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

24



Asimmetry LEFT LOBE


25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

25



Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Minoshima 2014



26

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

27




Attenzione



28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London


28

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

29

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

30

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

31







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London







32

Sommario

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

33

L-TYROSINE

L-DOPA

DA




34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London



34





34

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

35

123I-MIBG AD vs LBD

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

36





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London





bull Datscan SPET


37

Sommario

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Amyloid-PET

38

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Amyloid-PET

39



Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

Amyloid-PET

Regione Z-score

Prefrontal R 781

Prefrontal L 812





40


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London


DaTscan

POSITIVA

PDLBD

CBDMSAPSPPVFTD

NEGATIVA


MIBG

NEGATIVA

CBDMSAPSPPVAD

POSITIVA

PDLBD

FDG-PET


42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

42


43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

43

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

44




DOPAMINA123 FP-CIT

45


46







47

Conclusioni

48

Grazie



Jack London

45


46







47

Conclusioni

48

Grazie



Jack London

46







47

Conclusioni

48

Grazie



Jack London





47

Conclusioni

48

Grazie



Jack London

48

Grazie



Jack London

Ruolo della diagnostica SPET e PET · Baseline cognitive scores (A), regional 18F-FDG uptake (B),...

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Transcript of Ruolo della diagnostica SPET e PET · Baseline cognitive scores (A), regional 18F-FDG uptake (B),...