Technologist’s Guide

Brain Imaging

October 2015

Neurological disorders are already affecting hundreds of millions of people worldwide, of whom more than 50 million suffer from epilepsy and around 35.6 million have Alzheimer’s disease or other dementias. Furthermore, greater life expectancy and the overall ageing of the general population in both developed and developing countries will contribute to continued increases in the prevalence of many chronic and progressive physical and mental conditions, including neurological disorders.

Diagnostic nuclear medicine investigations have evolved from being a research modality in the evaluation of function and disease of the central nervous system to an established clinical tool in neurology. During recent years, new technologies and techniques have been developed in order to improve the quality of the images acquired, thereby enhancing the clinical impact of these techniques. Moreover, radiopharmaceutical development has allowed SPECT and PET imaging to become increasingly acute and to cover more pathologies. From metabolism to perfusion, brain function has been studied in a variety of conditions, including dementia, epilepsy, movement disorders and brain tumours. These advances represent a challenge for technologists, given that each new technique and piece of equipment requires optimisation of protocol design. In the neuroimaging context, technologists also play a key role in patient care, which can be particularly challenging owing to the inability of patients suffering from neurological disorders to cooperate and also the demanding nature of the examinations.   In this book, we begin by describing the brain’s anatomy, physiology and pathology (Chapter 1). After this, tracers for brain imaging are discussed (Chapter 2). The following two chapters provide an overview on the imaging of oncological disease by means of SPECT or SPECT/CT and PET/CT techniques (Chapters 3 and 4). Imaging in neurological and vascular brain diseases is also analysed, focussing first on SPECT and SPECT/CT technology and then on PET/CT (Chapters 5 and 6). The use of PET/CT in brain tumour radiotherapy planning is discussed in Chapter 7. The application of the emerging technology of PET/MRI for brain imaging is approached in Chapter 8. Brain imaging in the case of suspicion of brain death is described in Chapter 9. The final chapter is devoted to the special health care and surveillance needs of patients affected by neurological disorders. This extended overview of neuroimaging techniques and the clinical state of art will provide a valuable tool to all clinical staff, including not only technologists but also physicians, physicists and students interested in this particular field. The EANM Technologist Committee would like to thank all the authors who have kindly offered their time and expertise, which have been fundamental to the creation of this book.


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