PET and SPECT in Neurology

R.A.J.O. Diercks, A. Otte, E.F.J. de Vries, and A. van Waarde, eds.

New York, NY: Springer, 2014, 1,112 pages, $399

PET and SPECT in Neurology consists of 2 major sections. The first (part 1) covers the basics of using PET and SPECT to describe brain function and deals with tracer kinetics and quantification methods. In anticipation of the potential future clinical use of PET/MR imaging in neurology, the book also presents the use of MR techniques to examine blood flow, metabolism, and neuronal transmission. One can even find a description of the default-mode brain network on resting-state functional MR imaging, as well as interpretations in terms of the functional, structural, and metabolic networks.

In the second section of the book (parts 2–8), the clinical application and current status of using PET and SPECT imaging in several neurologic disorders are described, including dementia, cerebrovascular disorders, movement disorders, inflammation, epilepsy, and brain tumors. The clinical application of ¹⁸F-FDG and amyloid PET in dementia, and of dopamine transporter SPECT in movement disorders, are reviewed excellently in textbook fashion. The current knowledge on these topics is nothing new, but the information is strongly recommended for beginners in PET and SPECT who want to thoroughly and systematically learn the present status of these imaging techniques in neurology.

Besides covering PET and SPECT findings for Alzheimer disease and mild cognitive impairment, the book appropriately emphasizes PET and SPECT findings for vascular dementia. Associated MR findings are also described well, such as the white matter hyperintensity that can reflect microvascular injuries and thus explain dementia or cognitive impairment. Readers are also presented with the cerebrovascular risk factors for Alzheimer disease, as well as the tantalizing topic of the differential contribution of vascular and degenerative processes to a patient’s dementia. Readers will be led to ponder the sensitivity of this topic because of the fuzzy boundary between Alzheimer disease and subcortical vascular dementia. We might refine the PET and SPECT studies introduced in this book for possible use in discriminating or characterizing various conditions.

A few types of receptor PET are introduced, including imaging of the nicotinic acetylcholine receptor system and of inflammation in dementia. Considering the importance of inflammation in neurodegenerative and neuropsychiatric illnesses, the emphasis on neuroinflammation PET of microglial activation is appropriate. However, in another chapter, use of the different name of translocator protein PET/SPECT to describe the same technique for multiple sclerosis is annoying. In contrast, the decision to deal with carotid artery imaging of inflammation and atherosclerosis separately in 2 chapters is appealing. The book covers the most common study for imaging of carotid vulnerability in the clinic—¹⁸F-FDG PET—as well as introducing experimental or preclinical imaging of lipid accumulation, imaging of thrombosis, and angiogenesis imaging related to carotid atherosclerotic plaque. These topics seem sufficient to attract physicians’ interest.

The epilepsy studies in this book focus on novel PET ligands showing γ-aminobutyric acid–ergic transmission, serotonergic or opioid transmission, and P-glycoprotein 1. The listed functional PET studies have interesting findings in disclosing the pathophysiology of epilepsy and promise the future use of PET and SPECT in the development of antiepileptic drugs.

• © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.