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Training Collections
Library Memberships
Sale 25% OffOn-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Sale 25% OffPractice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Sale 30% OffUnlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
22 topics, 1 hr. 2 min.
Introduction to Neurodegenerative Diseases
3 m.Huntington’s Disease
3 m.Types of Movement Disorder
4 m.Extrapyramidal Anatomy
4 m.Neuroanatomy and Neurophysiology of the corpus striatum 1
4 m.Neuroanatomy and Neurophysiology of the corpus striatum 2
4 m.Huntington’s Chorea Case Review
5 m.Measurements and Ratios in Huntington’s Chorea
3 m.Epidemiology of Huntington's disease
5 m.Clinical Implications Part 2
4 m.Genetic Choreas
4 m.Imaging Differentiators in Genetic Choreas
3 m.Sydenham’s Chorea
4 m.Immunologic Causes of Chorea
3 m.Infectious Causes of Chorea
3 m.Drug Induced Choreas
3 m.Vascular Choreas
3 m.Neoplastic Disorder Choreas
2 m.Metabolic Causes of Chorea Part 1
2 m.Metabolic Causes of Chorea Part 2
3 m.MR Spectroscopy in Huntington's Chorea
3 m.Huntington’s Chorea on PET
3 m.9 topics, 26 min.
12 topics, 48 min.
Lipoid Proteinosis or Urbach-Wiethe Disease
3 m.Parkinson’s Disease (PD) vs Lewy Body Dementia (LBD)
5 m.Progressive Supranuclear Palsy (PSP)
6 m.Progressive Supranuclear Palsy (PSP) vs Creutzfeldt–Jakob disease (CJD)
4 m.Multiple System Atrophy (MSA)
3 m.Midbrain Anatomy: PSP
3 m.Bilateral Corpus Striatum Caudoputamen Hyperintensity Differential Diagnosis
6 m.Dystonia
6 m.Bilateral Corpus Striatum Caudoputamen Hyperintensity: Wilson’s Disease
5 m.Wilson’s Disease: Panda Sign
3 m.MSA Subtypes: MSA-C
5 m.Parkinsonian Syndromes: MSA-P
6 m.20 topics, 1 hr. 16 min.
Cerebellopontine Atrophy Differential in Older Population
7 m.GCA Scale for Assessing Neurodegenerative Disease
3 m.Medial Temporal Lobe Scale
3 m.Fazekas Scale
3 m.Koedam Parietal Atrophy Scale
3 m.Mild Cognitive Impairment Syndrome
8 m.Differential Diagnosis of Cognitive Decline
5 m.Alzheimer's Disease: Part 1
3 m.Alzheimer's Disease: Part 2
4 m.Creutzfeldt-Jakob Disease: Part 1
3 m.Creutzfeldt-Jakob Disease: Part 2
5 m.Subcortical arteriosclerotic encephalopathy
5 m.Using Fiber Tracking in Neurodegenerative Disease Cases
2 m.Vascular Dementia Differential Diagnosis: Part 1
5 m.Vascular Dementia Differential Diagnosis: Part 2
6 m.Dementia of Unknown Type
4 m.Pick's Disease
4 m.Pick’s Disease Subtypes
3 m.The Role of PET in Pick's disease
3 m.Differential Diagnosis of Parkinsonian Symptoms
5 m.0:00
There are other imaging options for
0:02
Parkinson's disease besides MRI,
0:05
and these include fluorodeoxyglucose PET,
0:08
which tends to be more valuable in individuals
0:11
that have a strong dementia component
0:13
to their Parkinson's disease,
0:15
to try and help differentiate Lewy Body
0:18
Dementia or Lewy Body Disease, LBD,
0:21
from classic PD or Parkinson's disease.
0:24
And we'll discuss a little bit later on how
0:27
you might use these techniques.
0:29
Fluorodopa PET gives you some specificity for
0:32
dopaminergic function in the brain,
0:35
although I found it less helpful as a standalone
0:38
technique to differentiate LBD,
0:41
Lewy Body Dementia,
0:42
from Parkinson's disease.
0:44
But it is a good way for research purposes and
0:47
treatment purposes to document the severity
0:51
and loss of dopaminergic function.
0:53
Now, this axial FLAIR image demonstrates
0:56
another finding of PD,
0:58
which is depigmentation of the red nucleus.
1:01
It's a pretty big structure, the nucleus ruber,
1:05
and it should be seen as a slightly,
1:07
at least slightly hypointense,
1:09
round structure on a FLAIR or a BSI,
1:12
or blood-sensitive image, or a gradient echo
1:15
or even a T2 or an echo planar image,
1:17
and we don't see it.
1:19
This axial view of a patient who has early
1:25
Parkinson's disease with two slices,
1:28
and later Parkinson's disease,
1:30
shows the effect of Flourodopa PET,
1:33
which is staining specifically for dopaminergic function.
1:38
On the upper images,
1:39
look how much more dopaminergic uptake we have.
1:43
Look at the thickness of the substantia nigra
1:46
compared to how thinned out it is
1:50
in late Parkinson's disease.
1:52
There's no uptake in the red nucleus.
1:55
It's been depigmented,
1:56
and the dopaminergic function
1:58
has essentially failed here.
2:00
And then look laterally how attenuated the lateral
2:04
uptake of Fluorodopa is in the outer half of the
2:08
substantia nigra in a patient with rigidity,
2:12
difficulty initiating movements,
2:15
resting tremor with classic Parkinson's disease.
2:19
Finally,
2:20
here's an FDG PET in a normal individual
2:24
and a fluorodopa PET in a normal individual,
2:27
showing nigral or striatal nigral uptake
2:32
that is rather intense on the Fluorodopa PET.
2:35
But in the Parkinson's patient,
2:37
not only are we able to see it,
2:38
we're also able to qualify and quantify
2:42
the degree of striatal nigral loss
2:46
in this axial specimen or axial
2:49
section from a PET.
2:50
Let's move on, shall we?
Interactive Transcript
0:00
There are other imaging options for
0:02
Parkinson's disease besides MRI,
0:05
and these include fluorodeoxyglucose PET,
0:08
which tends to be more valuable in individuals
0:11
that have a strong dementia component
0:13
to their Parkinson's disease,
0:15
to try and help differentiate Lewy Body
0:18
Dementia or Lewy Body Disease, LBD,
0:21
from classic PD or Parkinson's disease.
0:24
And we'll discuss a little bit later on how
0:27
you might use these techniques.
0:29
Fluorodopa PET gives you some specificity for
0:32
dopaminergic function in the brain,
0:35
although I found it less helpful as a standalone
0:38
technique to differentiate LBD,
0:41
Lewy Body Dementia,
0:42
from Parkinson's disease.
0:44
But it is a good way for research purposes and
0:47
treatment purposes to document the severity
0:51
and loss of dopaminergic function.
0:53
Now, this axial FLAIR image demonstrates
0:56
another finding of PD,
0:58
which is depigmentation of the red nucleus.
1:01
It's a pretty big structure, the nucleus ruber,
1:05
and it should be seen as a slightly,
1:07
at least slightly hypointense,
1:09
round structure on a FLAIR or a BSI,
1:12
or blood-sensitive image, or a gradient echo
1:15
or even a T2 or an echo planar image,
1:17
and we don't see it.
1:19
This axial view of a patient who has early
1:25
Parkinson's disease with two slices,
1:28
and later Parkinson's disease,
1:30
shows the effect of Flourodopa PET,
1:33
which is staining specifically for dopaminergic function.
1:38
On the upper images,
1:39
look how much more dopaminergic uptake we have.
1:43
Look at the thickness of the substantia nigra
1:46
compared to how thinned out it is
1:50
in late Parkinson's disease.
1:52
There's no uptake in the red nucleus.
1:55
It's been depigmented,
1:56
and the dopaminergic function
1:58
has essentially failed here.
2:00
And then look laterally how attenuated the lateral
2:04
uptake of Fluorodopa is in the outer half of the
2:08
substantia nigra in a patient with rigidity,
2:12
difficulty initiating movements,
2:15
resting tremor with classic Parkinson's disease.
2:19
Finally,
2:20
here's an FDG PET in a normal individual
2:24
and a fluorodopa PET in a normal individual,
2:27
showing nigral or striatal nigral uptake
2:32
that is rather intense on the Fluorodopa PET.
2:35
But in the Parkinson's patient,
2:37
not only are we able to see it,
2:38
we're also able to qualify and quantify
2:42
the degree of striatal nigral loss
2:46
in this axial specimen or axial
2:49
section from a PET.
2:50
Let's move on, shall we?
Report
Description
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
Tags
Syndromes
PET
Nuclear Medicine
Neuroradiology
Molecular Imaging
Drug related
Brain
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