[18F]FDG-PET zur Differenzialdiagnostik und Prognostik der neurodegenerativen Parkinson-Syndrome: Update 2022

Philipp T. Meyer; Joachim Brumberg; Carsten Buhmann; Ralph Buchert

doi:10.1055/a-1712-6125

Angewandte Nuklearmedizin, Table of Contents

Angewandte Nuklearmedizin 2022; 45(04): 286-296
DOI: 10.1055/a-1712-6125

Nuklearmedizinische Hirnbildgebung

Übersicht

[¹⁸F]FDG-PET zur Differenzialdiagnostik und Prognostik der neurodegenerativen Parkinson-Syndrome: Update 2022

[¹⁸F]FDG-PET for Differential Diagnosis and Prognosis of Neurodegenerative Parkinsonian Syndromes: Update 2022

Philipp T. Meyer

¹Klinik für Nuklearmedizin, Universitätsklinikum Freiburg, Freiburg, Deutschland (Ringgold ID: RIN14879)

,

Joachim Brumberg

¹Klinik für Nuklearmedizin, Universitätsklinikum Freiburg, Freiburg, Deutschland (Ringgold ID: RIN14879)

,

Carsten Buhmann

²Ambulanzzentrum und Klinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg

,

Ralph Buchert

³Abteilung für Nuklearmedizin, Zentrum für Radiologie und Endoskopie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland (Ringgold ID: RIN37734)

› Author Affiliations

Abstract

Zusammenfassung

Die Positronenemissionstomografie (PET) mit [¹⁸F]Fluordesoxyglukose ([¹⁸F]FDG) ist eine etablierte bildgebende Methode zur Diagnostik der neurodegenerativen Parkinson-Syndrome. In der vorliegenden Arbeit geben wir nach einer Einführung in den klinisch-neurologischen Kontext eine aktualisierte Übersicht über die mittlerweile sehr umfangreiche Evidenz (u.a. basierend auf post mortem Studien und aktuellen Metaanalysen), dass die [¹⁸F]FDG-PET erkrankungsspezifische Muster des zerebralen Glukosestoffwechsels bei den einzelnen Parkinson-Syndromen abbilden und damit einen über die klinische Diagnose hinausgehenden differenzialdiagnostischen Beitrag liefern kann. Dies betrifft sowohl die Abgrenzung des idiopathischen Parkinson-Syndroms (IPS) von den atypischen Parkinson-Syndromen (APS), als auch die Trennung der APS untereinander. Ferner fassen wir die aktuelle Studienlage zur Wertigkeit der [¹⁸F]FDG-PET zur Prognose der Entwicklung einer Demenz beim IPS zusammen. Hierbei gehen wir jeweils auch auf den Beitrag konkurrierender bildgebender Verfahren ein. Abschließend diskutieren wir jüngste technische Entwicklungen und die Kosteneffektivität der [¹⁸F]FDG-PET am Beispiel der Abklärung zur Tiefen-Hirnstimulation.

Abstract

Positron emission tomography (PET) with [¹⁸F]fluorodeoxyglucose ([¹⁸F]FDG) is an established imaging method for the diagnosis of neurodegenerative Parkinsonian syndromes. After an introduction of the clinical-neurological context, the present review gives an updated overview of current extensive evidence (among others based on post mortem studies and metaanalyses) that [¹⁸F]FDG-PET can depict disease-specific patterns of cerebral glucose metabolism in Parkinsonian syndromes and, thus, contribute to their differential diagnosis beyond clinical ratings. This does not only entail the distinction between Parkinson’s disease (PD) and atypical Parkinsonian Syndromes (APS) but also the differentiation among the APS. In addition, we summarize current studies addressing the value of [¹⁸F]FDG-PET for predicting the development of dementia in PD. We also report the merits of competing imaging methods. Finally, we discuss recent methodological developments and the cost effectiveness of [¹⁸F]FDG-PET with exemplary reference to the screening for deep brain stimulation.

Schlüsselwörter

Parkinson-Syndrom - PD - MSA - PSP - CBD - PET - zerebraler Glukosemetabolismus

Keywords

Parkinsonian syndrome - PD - MSA - PSP - CBD - PET - cerebral glucose metabolism

Full Text

References

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