Clinical Nuclear Medicine Neuroimaging. An Instructional Casebook

Chapter I Positive Emission Tomography (PET) in Dementia

* Normal FDG brain PET
* Probable normal aging
* Probable Mild cognitive impairment (MCI)
* Probable early onset of Alzheimer's disease (EOAD)
* Probable ate onset of AD (LOAD)
* Probable frontotemporal dementia (FTD)
* Probable behavioral variant FTD (fvFTD)
* Probable semantic variant FTD (svFTD)
* Probable corticobasal degeneration (CBD)
* Probable dementia with Lewy bodies (DLB)
* Possible AD with vascular dementia (VD) pathology
* Dementia likely resulting from traumatic brain injury (TBI)
* Probable vascular dementia (VD)
* Probable AD with DLB pathology
* Possible FTD with AD pathology
* Dementia likely secondary to major depression (MD)
* Aphasia resulting from arteriovenous malformation (AVM)
* Dementia due to CNS lymphoma
* Dementia of unknown type
* Negative Amyloid PET scan
* Positive Amyloid PET scan

Chapter II Single Photo Emission Computed Tomography (SPECT) in Dementia

* Probable normal brain perfusion SPECT
* Possible mild cognitive impairment (MCI)
* Possible Alzheimer's disease (AD)
* Probable early onset of AD (EOAD)
* Probable frontotemporal dementia (FTD)
* Probable behavioral variant FTD (bvFTD)
* Probable dementia with Lewy Bodies (DLB)
* Probable primary progressive aphasia (PPA) with AD pathology
* Probable vascular dementia (VAD)
* Probable DLB with pathology of Parkinson's disease and FTD

Chapter III FDG PET Imaging of Epilepsy

* Normal children's brain glucose metabolism
* LEFT temporal epilepsy
* RIGHT temporal epilepsy
* Frontal lobe epilepsy
* Parietal lobe epilepsy
* Occipital lobe epilepsy
* Ictal FDG PET study
* Seizures secondary to brain tumor
* Seizures due to birth injury
* Seizures due to shaking baby syndrome
* Seizures due to multiple tuberculosis

Chapter IV SPECT Imaging of Epilepsy

* Inter-ictal temporal epilepsy
* Inter-ictal frontal epilepsy
* Inter-ictal Amygdale epilepsy
* Inter-ictal parietal epilepsy
* Inter-ictal occipital epilepsy
* Ictal temporal epilepsy
* Ictal frontal epilepsy
* Ictal Amygdale epilepsy
* Ictal parietal epilepsy
* Ictal occipital epilepsy
* Combined ictal/inter-ictal study with SISCOM analysis

Chapter V. PET imaging of brain tumors

* CNS lymphoma
* Primary glioma
* Glioblastoma multiform (GBM)
* Recurrent glioma
* Metastatic lung cancer
* Metastatic melanoma

Chapter VI. DaTscanNormal DaTscan

* Early Parkinson's disease (PD)
* Advanced PD
* Abnormal DaTscan with findings corresponding to symptoms
* Abnormal study due to DLB
* Abnormal study due to CBD
* Abnormal study due to new onset of stroke

Chapter VI. SPECT Imaging of brain death

* Negative study with normal brain perfusion
* Positive study for brain death
* Questionable study

Chapter VII. SPECT imaging of Lyme Encephalopathy

* Early Lyme disease
* Lyme disease with mixed hyperperfusion and hypoperfusion
* Advanced Lyme disease
* Abnormal study with imaging follow-up

Chapter VIII. Nuclear Cisternogram

* Normal study
* Slow CSF flow due to brain atrophy/dilated ventricles
* Communicated NPH
* Non-communicated NPH
* Normal VP shunt study
* Occluded VP shunt
* Normal Ommaya shunt study
* Abnormal Ommaya shunt study
* CSF leak in cervical spine
* CSF leak in thoracic spine
* CSF leak in lumbar spine
* CSF leak in nasal cavity

Chapter IX. Miscellaneous

* WADA test on perfusion SPECT
* "Stealing phenomenon" on perfusion SPECT with Diamox
* FDG brain PET in encephalitis
* Diaschisis due to eye prosthesis

Chapter X. Self-Assessment Quiz

This book serves as a casebook for clinical nuclear medicine neuroimaging. Clinical interpretation of nuclear medicine neuroimaging studies is often challenging, mainly due to the complexity of neuroanatomy and a lack of supportive reference books. This is an unmet need in many teaching hospitals. Utilizing a hands-on, case-based approach, this textbook guides readers through clinical nuclear medicine neuroimaging of major neurological diseases and conditions, including dementia, epilepsy, and brain death. Included here are basic guidelines and techniques for nuclear medicine neuroimaging practices, set alongside case examples that include standardized imaging display and detailed interpretation. Each chapter begins with examples of normal brain imaging as a reference point for the remainder of the chapter, which then presents detailed case examples of these diseases through various imaging techniques. Each of the cases highlights clinical and imaging key findings and precise impressions. This is an ideal guide for residents, fellows, and even practicing nuclear medicine physicians as a reference and teaching tool for neuroimaging in clinical nuclear medicine. It will be of significant value to residents, trainees, and young physicians in preparation for their in-service tests and board examinations.

Dafang Wu, MD, PhD is a Professor in the Department of Diagnostic Radiology & Molecular Imaging at Oakland University William Beaumont School of Medicine.