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Molekulare Bildgebung bei neurologischen Erkrankungen

Molecular imaging in neurological diseases

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Zusammenfassung

Die Magnetresonanztomographie (MRT) weist als Standardverfahren bei neurodegenerativen und neuroonkologischen Fragestellungen eine eingeschränkte Sensitivität und Spezifität auf. Die nuklearmedizinische molekulare Bildgebung mit spezifischen Positronenemissionstomographie(PET)- und single-photon-emission-computed-tomography(SPECT)-Tracern ermöglicht die Darstellung verschiedener molekularer Targets bzw. Stoffwechselprozesse und stellt damit eine wichtige Ergänzung zur MRT dar. Hier sei exemplarisch auf die Darstellung des Aminosäuretransports im Rahmen neuroonkologischer Fragestellungen verwiesen, sowie auf die bereits im präklinischen Stadium der Alzheimer-Demenz nachweisbaren Amyloidablagerungen mit hierfür seit Kurzem zugelassenen PET-Tracern. Dieser Übersichtsbeitrag bespricht die klinische Bedeutung bzw. die Indikationen der folgenden nuklearmedizinischen Untersuchungsverfahren: der Amyloid-PET, der 18F-Fluordesoxyglucose-PET und der Dopamintransporter-SPECT im Rahmen der Demenzdiagnostik und der Differenzialdiagnose des Parkinsonsyndroms, sowie die Aminosäure-PET für die Diagnostik hirneigener Tumoren und die Somatostatinrezeptorbildgebung bei Meningeomen.

Abstract

In neurodegeneration and in neuro-oncology, the standard imaging procedure, magnetic resonance imaging (MRI), shows limited sensitivity and specificity. Molecular imaging with specific positron-emission tomography (PET) and single-photon emission computed tomography (SPECT) tracers allows various molecular targets and metabolic processes to be assessed and is thus a valuable adjunct to MRI. Two important examples are referred to here: amino acid transport for neuro-oncological issues, and the recently approved PET tracers for detecting amyloid depositions during the preclinical stage of Alzheimer’s disease. This review discusses the clinical relevance and indications for the following nuclear medicine imaging procedures: amyloid PET, 18F-fluorodeoxyglucose (FDG)-PET, and dopamine transporter (DaT)-SPECT for the diagnosis of dementia and the differential diagnosis of Parkinson’s disease, in addition to amino acid PET for the diagnosis of brain tumors and somatostatin receptor imaging in meningioma.

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  1. Abteilung Nuklearmedizin und Klinische Molekulare Bildgebung, Department Radiologie, Universitätsklinikum Tübingen, Otfried-Müller-Str. 14, 72076, Tübingen, Deutschland

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Reimold, M., la Fougère, C. Molekulare Bildgebung bei neurologischen Erkrankungen. Radiologe 56, 580–587 (2016). https://doi.org/10.1007/s00117-016-0124-8

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