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Moonis G, Subramaniam RM, Trofimova A, Burns J, Bykowski J, Chakraborty S, Holloway K, Ledbetter LN, Lee RK, Pannell JS, Pollock JM, Powers WJ, Roca RP, Rosenow JM, Shih RY, Utukuri PS, Corey AS. ACR Appropriateness Criteria® Dementia. J Am Coll Radiol 2020; 17:S100-S112. [PMID: 32370954 DOI: 10.1016/j.jacr.2020.01.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 12/24/2022]
Abstract
Degenerative disease of the central nervous system is a growing public health concern. The primary role of neuroimaging in the workup of patients with probable or possible Alzheimer disease has typically been to exclude other significant intracranial abnormalities. In general, the imaging findings in structural studies, such as MRI, are nonspecific and have limited potential in differentiating different types of dementia. Advanced imaging methods are not routinely used in community or general practices for the diagnosis or differentiation of forms of dementia. Nonetheless, in patients who have been evaluated by a dementia expert, FDG-PET helps to distinguish Alzheimer disease from frontotemporal dementia. In patients with suspected dementia with Lewy bodies, functional imaging of the dopamine transporter (ioflupane) using SPECT may be helpful. In patients with suspected normal-pressure hydrocephalus, DTPA cisternography and HMPAO SPECT/CT brain may provide assessment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Gul Moonis
- Columbia University Medical Center, New York, New York.
| | | | | | - Judah Burns
- Panel Chair, Montefiore Medical Center, Bronx, New York
| | | | - Santanu Chakraborty
- Ottawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada; Canadian Association of Radiologists
| | - Kathryn Holloway
- MCVH-Virginia Commonwealth University, Richmond, Virginia; Neurosurgery Expert
| | | | - Ryan K Lee
- Einstein Healthcare Network, Philadelphia, Pennsylvania
| | - Jeffrey S Pannell
- University of California San Diego Medical Center, San Diego, California
| | | | - William J Powers
- University of North Carolina School of Medicine, Chapel Hill, North Carolina; American Academy of Neurology
| | - Robert P Roca
- Sheppard Pratt Health System, Towson, Maryland; American Psychiatric Association
| | - Joshua M Rosenow
- Northwestern University Feinberg School of Medicine, Chicago, Illinois; Neurosurgery Expert
| | - Robert Y Shih
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | | | - Amanda S Corey
- Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia
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Yue X, Luo Z, Liu H, Kaneshige K, Parsons SM, Perlmutter JS, Tu Z. Radiosynthesis and evaluation of a fluorine-18 labeled radioligand targeting vesicular acetylcholine transporter. Bioorg Med Chem Lett 2018; 28:3425-3430. [PMID: 30274694 DOI: 10.1016/j.bmcl.2018.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 12/28/2022]
Abstract
Vesicular acetylcholine transporter (VAChT) is a reliable biomarker for assessing the loss of cholinergic neurons in the brain that is associated with cognitive impairment of patients. 5-Hydrotetralin compound (±)-5-OH-VAT is potent (Ki = 4.64 ± 0.32 nM) and selective for VAChT (>1800-fold and 398-fold for σ1 and σ2 receptor, respectively) with favorable hydrophilicity (LogD = 1.78), while (-)-5-OH-VAT originally serves as the radiolabeling precursor of (-)-[18F]VAT, a promising VAChT radiotracer with a logD value of 2.56. To evaluate (-)-5-OH-[18F]VAT as a radiotracer for VAChT, we performed in vitro binding assay to determine the potency of the minus enantiomer (-)-5-OH-VAT and plus enantiomer (+)-5-OH-VAT, indicating that (-)-5-OH-VAT is a more potent VAChT enantiomer. Radiosynthesis of (-)-5-OH-[18F]VAT was explored using three strategies. (-)-5-OH-[18F]VAT was achieved with a good yield (24 ± 6%) and high molar activity (∼37 GBq/µmol, at the end of synthesis) using a microwave assisted two-step one-pot procedure that started with di-MOM protected nitro-containing precursor (-)-6. MicroPET studies in the brain of nonhuman primate (NHP) suggest that (-)-5-OH-[18F]VAT readily penetrated the blood brain barrier and specifically accumulated in the VAChT-enriched striatum with improved washout kinetics from striatum compared to [18F]VAT. Nevertheless, the lower target to non-target ratio may limit its use for in vivo measurement of the VAChT level in the brain.
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Affiliation(s)
- Xuyi Yue
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, United States
| | - Zonghua Luo
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, United States
| | - Hui Liu
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, United States
| | - Kota Kaneshige
- Department of Chemistry and Biochemistry, University of California, Santa Barbara, CA 93106, United States
| | - Stanley M Parsons
- Department of Chemistry and Biochemistry, University of California, Santa Barbara, CA 93106, United States
| | - Joel S Perlmutter
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, United States; Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, United States
| | - Zhude Tu
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, United States.
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ACR Appropriateness Criteria Dementia and Movement Disorders. J Am Coll Radiol 2015; 12:19-28. [DOI: 10.1016/j.jacr.2014.09.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 09/14/2014] [Accepted: 09/15/2014] [Indexed: 11/22/2022]
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Zhuang L, Liu X, Xu X, Yue C, Shu H, Bai F, Yu H, Shi Y, Zhang Z. Association of the interleukin 1 beta gene and brain spontaneous activity in amnestic mild cognitive impairment. J Neuroinflammation 2012. [PMID: 23199001 PMCID: PMC3541073 DOI: 10.1186/1742-2094-9-263] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose The inflammatory response has been associated with the pathogenesis of Alzheimer’s disease (AD). The purpose of this study is to determine whether the rs1143627 polymorphism of the interleukin-1 beta (IL-1β) gene moderates functional magnetic resonance imaging (fMRI)-measured brain regional activity in amnestic mild cognitive impairment (aMCI). Methods Eighty older participants (47 with aMCI and 33 healthy controls) were recruited for this study. All of the participants were genotyped for variant rs1143627 in the IL1B gene and were scanned using resting-state fMRI. Brain activity was assessed by amplitude of low-frequency fluctuation (ALFF). Results aMCI patients had abnormal ALFF in many brain regions, including decreases in the inferior frontal gyrus, the superior temporal lobe and the middle temporal lobe, and increases in the occipital cortex (calcarine), parietal cortex (Pcu) and cerebellar cortex. The regions associated with an interaction of group X genotypes of rs1143627 C/T were the parietal cortex (left Pcu), frontal cortex (left superior, middle, and medial gyrus, right anterior cingulum), occipital cortex (left middle lobe, left cuneus) and the bilateral posterior lobes of the cerebellum. Regarding the behavioral significance, there were significant correlations between ALFF in different regions of the brain and with the cognitive scores of each genotype group. Conclusions The present study provided evidence that aMCI patients had abnormal ALFF in many brain regions. Specifically, the rs1143627 C/T polymorphism of the IL1B gene may modulate regional spontaneous brain activity in aMCI patients.
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Affiliation(s)
- Liying Zhuang
- Medical School of Southeast University, Nanjing, Jiangsu 210009, China
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Bohnen NI, Djang DSW, Herholz K, Anzai Y, Minoshima S. Effectiveness and safety of 18F-FDG PET in the evaluation of dementia: a review of the recent literature. J Nucl Med 2011; 53:59-71. [PMID: 22173840 DOI: 10.2967/jnumed.111.096578] [Citation(s) in RCA: 189] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Imaging that can detect pathophysiologic change in the brain holds great promise for diagnostic assessment of patients with Alzheimer disease (AD) and dementia. Although a previous metaanalysis centering on literature from 1990 to 2000 showed a summary accuracy of 86% for (18)F-FDG PET for AD diagnosis, the clinical value was considered uncertain because of methodologic shortcomings. Review of the recent literature since 2000 demonstrates that the evidence for (18)F-FDG PET in assessment of dementia has increased with new studies that include autopsy confirmation, wide-diagnostic-spectrum recruitment in primary care settings, historical and prospective cohort studies, and multicenter data analyses. These data support the role of (18)F-FDG PET as an effective and useful adjunct to other diagnostic information in the assessment of patients with symptoms of dementia. Findings are in line with recently revised diagnostic criteria of AD that for the first time recognize the unique role of biomarker evidence in disease definition.
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Affiliation(s)
- Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-0028, USA.
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Jia J, Sun B, Guo Z, Zhang J, Tian J, Tang H, Wang L. Positron emission tomography with Pittsburgh compound B in diagnosis of early stage Alzheimer's disease. Cell Biochem Biophys 2010; 59:57-62. [PMID: 20714824 DOI: 10.1007/s12013-010-9111-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In order to evaluate the role of positron emission tomography (PET) with N-methyl-[(11)C]-2-(4'-methylaminophenyl)-6-hydroxybenzothiazole, also known as Pittsburgh compound B (PIB), in the early diagnosis of Alzheimer's disease (AD). Clinical data were collected, and PIB PET cerebral imaging was performed in patients with AD (n = 6), mild cognitive impairment (MCI) (n = 7), and elderly, mentally normal controls (NCs) (n = 7). PET images of the subjects were then analyzed. Visual analysis showed that the radioactivity clearance rate in AD patients was significantly different from that found in the NC group. Furthermore, the radioactivity clearance rate 45 min after PIB injection was significantly lower than the NC group. Images from the MCI group presented heterogeneous results, overlapping with those from both the AD and NC groups. Statistical analysis showed that the radioactivity clearance rate during 5-45 min post-injection was significantly lower in the AD group (41-77%) than the control group (75-81%) (P > 0.05) and the MCI group (59-77%). The radioactivity clearance rate in the bilateral parietal lobes, frontal, temporal, and right occipital lobes, and the bilateral corpora striata in MCI group were lower than that in control group (P < 0.05). PIB PET brain imaging can differentiate early AD patients from NCs and may have certain value in identifying patients progressing to MCI.
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Affiliation(s)
- Jianjun Jia
- Department of Geriatric Neurology, PLA General Hospital, Beijing, China.
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EOM KIDONG, LIM CHAEYOUNG, GU SUHYUN, KANG BYEONGTECK, KIM YOUNGBO, JANG DONGPYO, WOO EUNGJE, KIM DAEYOUNG, CHO ZANGHEE, PARK HEEMYUNG. POSITRON EMISSION TOMOGRAPHY FEATURES OF CANINE NECROTIZING MENINGOENCEPHALITIS. Vet Radiol Ultrasound 2008; 49:595-9. [DOI: 10.1111/j.1740-8261.2008.00437.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
The history of the development of cerebral imaging is a complex combination of the forces of innovation at both the individual and industrial levels. Principal paradigms of neuroimaging shifted as a result of technological breakthroughs, beginning with the discovery of x-rays and continuing with the development of computerized imaging to the latest imaging paradigm, nuclear magnetic resonance imaging. We discuss these landmarks in neuroimaging in historical context, with emphasis on the particularly rapid development of imaging technology during the past 30 to 40 years, including the most recent emerging technologies.
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Affiliation(s)
- Paul E Kim
- Department of Radiology, Division of Neuroradiology, Keck School of Medicine, University of Southern California, 1200 North State Street, Room 3740, Los Angeles, California 90033, USA.
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Weintraub NT, Charette S. Encouraging geriatric medicine fellows to write review articles: a description of our experience. J Am Med Dir Assoc 2008; 9:215-8. [PMID: 18457796 DOI: 10.1016/j.jamda.2007.12.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Accepted: 12/13/2007] [Indexed: 10/22/2022]
Abstract
Medical education in the United States develops many skills, but writing is not usually one of them. At the UCLA Multicampus Division of Geriatrics, we recently instituted a project that attempts to provide the opportunity for each of our Geriatric Medicine fellows to write and publish a review article. We report our experiences of the first 3 years of this program in an effort to share our successes, our shortcomings and our impressions.
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Affiliation(s)
- Nancy T Weintraub
- Greater Los Angeles Veterans Affairs Medical Center, Geriatric Research Education Clinical Center, Sepulveda, CA, USA.
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Lucignani G. Clinical neuroimaging: a matter of biophysics and logistics. Eur J Nucl Med Mol Imaging 2007; 34:951-6. [PMID: 17479260 DOI: 10.1007/s00259-007-0448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Giovanni Lucignani
- Institute of Radiological Sciences, University of Milan, Unit of Nuclear Medicine, Hospital San Paolo, Via Antonio di Rudinì, 8, 20142, Milan, Italy.
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