TY - JOUR T1 - Routine 18F-FDG Brain PET/MRI Fused Images Outperforms Each Modality Alone in Evaluation of Movement Disorders. JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 993 LP - 993 VL - 58 IS - supplement 1 AU - Jose Leite Y1 - 2017/05/01 UR - http://jnm.snmjournals.org/content/58/supplement_1/993.abstract N2 - 993Objectives: The aim of this study is to ilustrate applications of PET/MRI hybrid systems trough routine PET and MRI coregistration of the brain in evaluation of movement disordes.Methods: From December/2014 to December/2015, neurological FDG-PET (Siemens Biograph TruePoint PET-CT) and MRI (Philips Intera 1.5 Tesla) examinations were performed in eight patients being evaluated for movement disorders. The PET and MRI images were co-registered in the Leonardo Siemens ® workstation, where they were read together by a Nuclear Medicine Physician (10 years experience) and a Neuroradiologist (14 years experiece). Imaging findings were correlated with all the clinical data and follow up of these patients.Results: From the eight patients being scanned, we selected the four most interesting cases based on the the findings of PET, MRI and PET/MRI fused images in correlation with clinical data and follow up.The first case is a 64 yo male with atypical parkinsonism refractory to L-DOPA medication. The FDG-PET findings of high uptake in the striatum and low uptake in the temporo-parietal cortex as well occipital (specially in this last one) suggested a Parkinson disease. MRI rule out other causes of the movement disorder (vascular, tumor etc).The second case was also an atypical parkinsonism refractory to L-DOPA medication in a 42 yo female. Different from the first case the associative and visual cortex glycolytic metabolism were preserved. However, it was a very pronounced hypometabolism in the brainstem, cerebellum and striatum. MRI revealed incipient atrophy findings of the brainstem and pons. Final diagnosis was multiple system atrophy. The third case is a 79 yo male with movement disorder and also cognition decline. The FDG-PET looked like very similar to an Alzheimer disease (bilateral low temporo-parietal cortex uptake). However, it was also clear very low uptake in the occipital cortex. The MRI spectroscopy of the posterior cingulate gyrus showed normal Naa metabolite which doesn't happens in Alzheimer disease. The Lewy body dementia was the final diagnosis.The last case was also a movement disorder associated with decline in cognition on a 81 yo female. Different from the third case, the associative and visual cortex glycolytic metabolism were preserved. However it were a pronounced hypometabolims in the midbrain, pons and cerebellum, correlated with signs of atrophy on MRI, highlighted with the Hummingbird sign on the midbrain. Also, no uptake were seen on the the olives which were also atrophied. Final diagnosis was an olivopontocerebellar atrophy.Conclusion: 18F-FDG PET/MRI hybrid systems trough routine PET and MRI coregistration of the brain seems to outperforms each modality alone on the evaluation of patients with movement disordes. Research Support: No research support. ER -