Alz imaging

Question 1

Imaging techniques used in clinical setting

Answer 1

For diagnosed dementia:
CT in most cases
FDG PET for DDX if will affect Mx, or atypical dementia
SPECT rCBF for above if FDG PET not avaialble
MRI if unsuspected VD will change management, or if specialized centre who can interpret in a way that will change Mx
MRI is better than CT

For MCI: partial consensus in specialized centres to do:
FDG PET for DDX if will affect Mx
SPECT rCBF for above if FDG PET not available.

Question 2

Imaging techniques in research

Answer 2

PET Amyloid imaging (do not do in asymptomatic person for clinical reasons, could do in rare complicated dementia cases)
fMRI (unclear predictive value)
MR spectroscopy (promising in telling who will convert from MCI).

Question 3

rapidly progressive dementia?

Answer 3

fall in MMSE of 3 within 6 months
dementia within 6 months of 1st cognitive sx
refer to memory clinic
RO other cause

Question 4

CSF biomarkers?
clinically?
research?

Answer 4

CSF:
A-beta 1-42
total tau
phosphorelated tau

Not clinically
yes for research