Clinical Nuclear Medicine in Neurology : An Atlas of Challenging Cases

This book gathers a collection of cases with challenging diagnoses, in which nuclear medicine examinations have been particularly helpful in terms of the final diagnosis or follow-up. The cases presented chiefly involve patients with neurodegenerative disorders, epilepsy and brain tumors. The book is intended for nuclear medicine specialists as well as clinicians, offering essential guidance on the interpretation of neurology cases in the clinical setting, particularly with regard to correctly interpreting diagnostic imaging procedures. The authors were selected from the members of the Neuroimaging Committee of the EANM and have extensive experience as clinicians and teachers within the Nuclear Medicine Community. Preface Contents Section I: Nuclear Medicine Cases of Dementia and Movement Disorders Case 1: Mild Cognitive Impairment (MCI)—[18F]FDG and Amyloid PET Background Patient’s Characteristics Woman, 76-Years-Old; Right-Handed; 13 Years of Education Suggested Reading Case 2: Alzheimer’s Disease—[18F]FDG, Tau, and Amyloid PET Case Summary Images/Findings Diagnosis Discussion Conclusions References Case 3: Alzheimer’s Disease—Behavioral Variant Introduction Case Presentation Imaging Findings Suggested Readings Case 4: Parkinson’s Disease with Onset as Mild Cognitive Impairment (MCI) Introduction Case Presentation Imaging Findings Suggested Reading Case 5: Parkinson’s Disease with Vascular Abnormalities Clinical Background Dopamine Transporter SPECT Scan Conclusion Course Discussion References Case 6: Parkinson’s Disease with Left-Sided Spasticity Clinical Background Imaging MRI Scan Dopamine Transporter SPECT Scan Conclusion Course Discussion References Case 7: Holmes Tremor Case Summary Epidemiology Clinical Features Pathology and Cause Clinical Management Imaging Findings Further Reading Case 8: Multiple System Atrophy with DAT SPECT and [18F]FDG PET Background Case Presentation Figures Legend Suggested Reading Case 9: Progressive Supranuclear Palsy: Richardson Syndrome and Parkinsonian Variants Case 1 Summary Images/Findings Diagnosis Case 1 Case 2 Summary Images/Findings Diagnosis Case 2 Discussion Conclusions References Case 10: Progressive Supranuclear Palsy (PSP) Introduction Case Presentation Imaging Findings Suggested Reading Case 11: Corticobasal Syndrome: [18F]FDG and Amyloid PET Case Summary Imaging/Findings Diagnosis Discussion Conclusions References Case 12: Huntington’s Disease with Atypical Onset Introduction Case Presentation Clinical Presentation and Past Clinical History Neurological Evaluation Imaging Evaluation Suggested Reading Case 13: Huntington’s Disease with Psychiatric Onset Introduction Case Presentation Imaging Findings Further Reading Case 14: Creutzfeldt–Jakob Disease with Pathological Confirmation Case Summary Images/Findings Diagnosis Discussion Conclusions References Section II: Nuclear Medicine Cases of Epilepsy and Encephalitis Case 15: Non-lesional Temporal Epilepsy Introduction Case Presentation Methods Imaging Findings Follow-Up Information References Case 16: Ictal [18F]FDG PET Imaging Introduction Case Presentation Methods Imaging Findings Follow-Up Information References Case 17: Focal Refractory Epilepsy with Negative MRI Case Summary Epidemiology Pathology and Etiology Imaging Findings Further Reading Case 18: Metabolic Abnormalities After Failed Resective Temporal Epilepsy Surgery Introduction Case Presentation Methods Imaging Findings Follow-Up Information References Case 19: Hypothalamic Hamartoma with Cortical Metabolic Abnormalities Introduction Case Presentation Methods Imaging Findings Follow-Up Information References Case 20: Autoimmune Encephalitis with Unusual Antibodies Case Summary Images/Findings Diagnosis Discussion Conclusions References Case 21: Psychiatric Presentation of Anti-N-Methyl-d-Aspartate Receptor (NMDAR) Limbic Encephalitis Case Summary Epidemiology Pathology Clinical Findings Treatment Imaging Findings Further Reading Case 22: Hashimoto Encephalitis Epidemiology Clinical Features Pathology Clinical Management Imaging Findings Further Reading Section III: Nuclear Medicine Cases of Brain Tumors Case 23: Pseudoresponse in Glioblastoma Patient Background Occurrence Imaging Findings Clinical Management Further Reading Case 24: Progressive Glioma Patient Background Imaging Findings Clinical Management Further Reading Case 25: Primary Diagnosis of an Isocitrate Dehydrogenase (IDH) Wild-Type Glioma References Case 26: Postoperative Meningioma Patient Epidemiology Pathology Background Imaging Findings Clinical Management Further Reading Case 27: Meningioma with Difficult Delineation on MRI References Case 28: Optic Nerve Sheath Meningioma (ONSM) Case Summary Epidemiology Pathology Clinical Features Clinical Management Imaging Findings Further Reading Case 29: Primary Brain Lymphoma Case Summary Images/Findings Diagnosis Discussion Conclusions References Case 30: Neurolymphomatosis Case Summary Epidemiology Pathology and Cause Clinical Features Clinical Management Imaging Findings Further Reading Case 31: Atypical Teratoid Rhabdoid Tumor (ATRT): Identification of Altered Cerebrospinal Fluid Circulation Impacting Intrathecal Chemotherapy Epidemiology Imaging Techniques Clinical History Closing Remarks References Case 32: Suspected Recurrence of Brain Metastasis After Radiotherapy References Case 33: Tumefactive Multiple Sclerosis Lesions (TMS) Introduction Case Presentation Imaging Findings Suggested Readings Section IV: PET/MRI and Challenging Cases Case 34: Typical AD with Discordant Biomarkers Clinical Presentation Imaging Findings Reference Case 35: Frontotemporal Dementia, Behavioural Variant, Mimicker Case Description Usual Imaging Findings in Strategic Infarcts Usual Clinical Presentation of Strategic Infarcts References Case 36: Creutzfeldt–Jakob Disease Clinical Presentation Imaging Findings References Case 37: Atypical Upper Motor Neuron Disease Background Clinical Presentation Imaging and Biopsy Findings Discussion References Case 38: Non-Lesional Epilepsy: A Tricky Case Introduction Clinical History Presurgical Work-Up Prolonged Video-EEG Monitoring Neuropsychological Testing Structural and Functional MRI 2-[18F]Fluoro-2-Deoxy-d-Glucose (FDG) PET/MR Invasive Video-EEG Monitoring Surgery, Histopathology, and Postoperative Surgical Outcome Closing Remarks References Case 39: Limbic Encephalitis Clinical Presentation Imaging Findings Further Reading