%0 Journal Article %A Joseph Hoang %A Philip Scherer %T A Review of CNS Nuclear Medicine Imaging – Dementia, Seizures, Tremors, and More %D 2022 %J Journal of Nuclear Medicine %P 2646-2646 %V 63 %N supplement 2 %X 2646 Introduction: Discuss the clinically available radiotracers utilized for central nervous system (CNS) nuclear medicine imaging, including 18F-FDG, 18F-Florbetapir, I-123 Ioflupane, In-111 DTPA, and Tc-99m DTPA / HMPAO / ECD. Discuss the clinical role of brain perfusion scintigraphy and FDG PET in the presurgical work-up of epilepsy. Examine the characteristic patterns of dementia and parkinsonism disorders with PET imaging and DATscan. Examine cerebral perfusion scintigraphy in the setting of epilepsy, brain death and vascular disease. Examine the role of FDG PET in differentiating radiation necrosis and residual / recurrent brain tumor. Elucidate the clinical utility of 111In and 99mTc DTPA in cerebral spinal fluid (CSF) imaging to evaluate for hydrocephalus, CSF leak and ventriculoperitoneal (VP) shunt patency. Review clinical PET and radionuclide scintigraphy cases involving intracranial tumors, dementia, parkinsonism disorders, epilepsy, brain death, CSF leak and shunt patency.Methods: Review of the current literature regarding PET and radionuclide scintigraphy for assessing central nervous system diseases and pathologies. Comparison of the diagnostic utility of nuclear medicine imaging with conventional radiology modalities (radiography, CT, and MR) in the characterization of central nervous system disease. Presentation of high yield clinical cases of Brain PET and CNS scintigraphy performed for intracranial tumors, dementia, tremors, seizure focus localization, brain death, and normal pressure hydrocephalus / CSF leak / VP shunt patency.Results: FDG PET can help differentiate residual / recurrent brain tumor from radiation necrosis. Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia and parkinsonian syndromes demonstrate characteristic patterns of radionuclide activity with FDG PET, amyloid imaging, and DATscan, respectively. FDG PET and radionuclide brain perfusion scintigraphy improves localization of epileptic seizure focus in conjunction with EEG and anatomic imaging. Brain perfusion scintigraphy is a clinically useful tool for confirming a clinical diagnosis of brain death. Utilization of 111-In and 99mTc-DTPA is an excellent, noninvasive approach to evaluate cerebrospinal flow within the ventricular system in the setting of VP shunt patency, normal pressure hydrocephalus, or CSF leak. Conclusions: Nuclear medicine imaging is an excellent modality with high clinical utility for diagnosing and characterizing varying diseases and pathologies involving the central nervous system. %U