Neuroimaging clinics of North America
-
Neuroimaging Clin. N. Am. · Nov 2003
Review Historical ArticleMolecular imaging of the brain: a historical perspective.
The rapid expansion of modern molecular imaging methods since the time of their initial conception in the 1970s has given rise to numerous discoveries of molecular mechanisms that underlie brain function in health and disease. Uses in clinical diagnosis and therapy monitoring are still evolving. Future clinical trials, in which molecular imaging is imbedded and correlated with clinical outcomes, will be critical to advancing new uses for patient management. Receptor occupancy studies are already well integrated into many drug development studies and clinical trials; such studies will provide a basis for new studies that will further advance clinical uses of brain molecular imaging.
-
The past 40 years have seen PET scanning evolve from a tool that was used predominantly for research to a valued clinical, imaging modality. Current PET scanners must perform high quality, whole-body, as well as brain, PET. ⋯ Several manufacturers now provide hybrid PET-CT scanners. There is also a growing interest in dedicated devices for specific applications, such as high-resolution scanners for imaging small animals.
-
Neuroimaging Clin. N. Am. · Nov 2003
ReviewThe role of positron emission tomography imaging in movement disorders.
PET imaging provides the means to study neurochemical, hemodynamic, or metabolic processes that underlie movement disorders in vivo. Because the extent of presynaptic nigrostriatal dopaminergic denervation can be quantified in PD even at an early or preclinical stage of the disease, PET imaging may allow the selection of at-risk subjects for neuroprotective intervention trials. These techniques may also provide markers to follow progression of disease or evaluate the effects of neurorestorative interventions in patients who have more advanced disease. ⋯ Studies have shown striatal dopamine receptor loss in selected subtypes of dystonic patients. In conclusion, it is expected that PET will help us to better understand the pathophysiology of movement disorders, increase the diagnostic accuracy, allow preclinical diagnosis, monitor disease progression, and evaluate the efficacy of therapeutic agents. Pharmacologic radioligand displacement studies and the development of new nondopaminergic ligands may further aid in the unraveling of cerebral mechanisms that underlie movement disorders.
-
Neuroimaging Clin. N. Am. · Nov 2003
ReviewNeuroimaging and mechanisms of drug abuse: interface of molecular imaging and molecular genetics.
Whereas ligand studies can inform the end-products of dysregulation of genetic expression, reporter gene imaging can provide the means to understand the genetic origin of these end-products. As with radioligand studies, in vivo direct measurement of gene expression will allow genetic processes to be monitored over time in the same subject, use of a subject as his/her own control in intervention studies (i.e., measurement before and after an intervention), and monitoring the spatial distribution of molecular events in the whole brain. Furthermore, reporter gene imaging, by advancing knowledge of the biologic mechanisms of disease states, has important clinical implications, particularly in the development and monitoring of treatments. We expect PET to play a prominent role in the elucidation of substance abuse mechanisms and contribute significantly to the development of innovative treatment strategies.
-
Neuroimaging Clin. N. Am. · Nov 2003
ReviewPositron emission tomography and single photon emission CT molecular imaging in schizophrenia.
We reviewed findings from PET and SPECT studies that have contributed to our understanding of the pathophysiology and treatment of schizophrenia. The most robust set of findings pertains to imaging of presynaptic dopaminergic function in the striatum. The results of these studies have been consistent in showing that schizophrenia, at least during episodes of illness exacerbation, is associated with increased activity of DA neurons; this increased presynaptic activity is associated with positive symptoms and good therapeutic response. ⋯ The results that have been produced by this field to date suggest that PET will significantly contribute to unraveling the biologic bases of psychiatric disorders and may contribute to their clinical management. Moreover, it is foreseeable that PET will become increasingly involved in the development of new psychiatric medications. Expanding the availability of PET and the current radiopharmaceutical portfolio will be critical for these predictions to become reality.