E1154. Nuclear Dementia Imaging: A Guide for the General and Trainee Radiologist
  1. Peter Jarvis; University Hospital Dorset
  2. Richard Hughes; University Hospital Dorset
  3. Amit Parekh; University Hospital Dorset
Dementia is a syndrome with multiple potential causes which is increasing in prevalence worldwide. Accurate and early diagnosis of the underlying etiology will be essential for targeting future interventions. There has been rapid development in functional imaging, which now has a key role alongside structural imaging in this diagnostic pathway. Increasing awareness among radiologists of the advantages and disadvantages of functional imaging and when it is appropriate to request these scans will improve patient care and reduce unnecessary imaging.

Educational Goals / Teaching Points
An overview of the different molecular imaging techniques, with sample protocols, used in the diagnostic work up of dementia is provided. We explore normal brain imaging using FDG PET/CT and describe typical changes seen in ageing. This is followed by a pictorial review, including strategies to identify the most common dementia subtypes using FDG PET/CT examples. We also look into the specific role of DaTscan imaging in the diagnosis of Parkinson’s disease and Lewy body dementia. Afterwards we establish which patients may benefit from molecular imaging and suggest a potential diagnostic pathway to be used in conjunction with conventional structural imaging. To finish, we explore some of the newer molecular imaging techniques currently in practice and under development for the diagnosis of dementia.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We present typical FDG PET/CT examples of common dementia subtypes including Alzheimer’s disease, mild cognitive impairment, frontotemporal dementia, semantic dementia, and Lewy body dementia. In addition we provide examples of DaTscan images in the diagnosis of Parkinson's disease and Lewy body dementia. We finish by looking into some of the newer molecular imaging techniques currently in use or development, including amyloid, tau and TSPO PET/CT.

A good understanding of the available functional and molecular imaging techniques used in the diagnostic workup of dementia will aid clinicians with early and accurate diagnosis. This will lead to faster diagnosis, earlier potential intervention and ultimately improved patient care.