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Update on PET in neurodegenerative and neuroinflammatory disorders manifesting on a behavioural level

imaging for differential diagnosis

Hellwig, Sabinea; Domschke, Katharinaa,b; Meyer, Philipp T.c

doi: 10.1097/WCO.0000000000000706
NEUROIMAGING: Edited by Stefan Klöppel
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Purpose of review To give an update on recent findings concerning the use of PET for differential diagnosis in neurodegenerative and neuroinflammatory disorders manifesting on a behavioural level.

Recent findings Although accurate differential diagnosis of dementia can be achieved by imaging disease-specific patterns of cerebral glucose metabolism with [18F]fluorodeoxyglucose ([18F]FDG)-PET, the diagnostic impact of [18F]FDG-PET in primary psychiatric disorders is limited. Amyloid-beta PET provides an incremental value beyond [18F]FDG-PET in the differential diagnosis of dementia and was proposed as a biomarker defining the so-called Alzheimer continuum. Recently developed tau-specific tracers might also aid in the diagnostic process (biological definition of Alzheimer's disease together with amyloid-beta). Surpassing the diagnostic accuracy of other techniques, such as MRI, [18F]FDG-PET has also gained widespread clinical use for diagnosis and follow-up of paraneoplastic and autoimmune disorders of the central nervous system (CNS) as an important differential diagnosis for rapid progressive dementia and subacute onset of psychiatric syndromes.

Summary Molecular neuroimaging with PET is an established method for the differential diagnosis of neurodegenerative and autoimmune CNS disorders manifesting on a behavioural level with significant therapeutic and prognostic impact. Future prospective studies are needed to define the value of tau imaging for diagnosis and prognosis in neurodegenerative disorders.

aDepartment of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine

bCenter for Neuro Modulation, Faculty of Medicine, University of Freiburg

cDepartment of Nuclear Medicine, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

Correspondence to Sabine Hellwig, MD, Department of Psychiatry und Psychotherapy, Medical Center – University of Freiburg, Hauptstr. 5,79104 Freiburg, Germany. Tel:+49 761 270 65010; fax: +49 761 270 65230; e-mail: sabine.hellwig@uniklinik-freiburg.de

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