7. Nuclear medicine diagnostics in neurology: perfusion, tumourotropic and receptor scintigraphy of the brain. Application of SPECT-CT.
Explains brain receptor scintigraphy, focusing on dopamine transporter imaging with I-123 ioflupane in movement disorders, covering the striatal binding principle, clinical uses such as Parkinson disease and essential tremor, and how normal and reduced uptake appear on the scan. It then outlines the advantages and limitations of combining SPECT with CT, and briefly covers bone scintigraphy using 99mTc-MDP, with its indications and the hot and cold spot patterns to look for.
Topic 7 of 50 in the MU Sofia syllabus for Nuclear Medicine (Medicine, Year 4). The free AceMed note covers it in 4 sections, about 371 words (4 min of reading), with 12 flashcards.
In this note
Brain Receptor Scintigraphy
Most Common Application
Application of SPECT/CT.
Nuclear medicine diagnostics of the joints. Nuclear medicine diagnostics of the bones: static and dynamic scintigraphy
Brain Receptor Scintigraphy
Brain receptor scintigraphy evaluates specific neurotransmitter receptors rather than blood flow.
It assesses receptor density and function.
Most Common Application
Dopamine Transporter (DAT) Imaging
Used in movement disorders.
Radiopharmaceuticals include iodine-labeled dopamine transporter tracers (e.g., I-123 ioflupane, also known as DaTSCAN®).
Principle
The tracer binds to dopamine transporters in the: Striatum
Normal: High uptake.
Parkinsonian syndromes:
↓
Reduced uptake.
Clinical Applications
Parkinson disease.
Parkinson-plus syndromes.
Differentiating essential tremor from Parkinson disease.
Interpretation
Normal scan:
Two symmetrical comma-shaped areas of uptake. Caudate and putamen
Parkinson disease:
Reduced uptake.
One or both commas become faint or shortened, eventually appearing as dots in advanced disease.
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