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Abstract
SUMMARY: The clinical standard of care in the diagnosis of neurodegenerative diseases relies on [18F] FDG-PET/CT or PET MR imaging. Limitations of FDG-PET include cost, the need for IV access, radiation exposure, and availability. Arterial spin-labeling MR imaging has been shown in research settings to be useful as a proxy for FDG-PET in differentiating Alzheimer disease from frontotemporal dementia. However, it is not yet widely used in clinical practice, except in cerebrovascular disease. Here, we present 7 patients, imaged with our routine clinical protocol with diverse presentations of Alzheimer disease and other neurodegenerative diseases, in whom arterial spin-labeling–derived reduced CBF correlated with hypometabolism or amyloid/tau deposition on PET. Our case series illustrates the clinical diagnostic utility of arterial spin-labeling MR imaging as a fast, accessible, and noncontrast screening tool for neurodegenerative disease. Arterial spin-labeling MR imaging can guide patient selection for subsequent PET or fluid biomarker work-up, as well as for possible therapy with antiamyloid monoclonal antibodies.
ABBREVIATIONS:
- AD
- Alzheimer disease
- ADLs
- activities of daily living
- ASL
- arterial spin-labeling
- CI
- cognitive impairment
- COVID-19
- coronavirus 2019
- lvPPA
- logopenic variant progressive aphasia
- MCI
- mild cognitive impairment
- MoCA
- Montreal Cognitive Assessment
- PCA
- posterior cortical atrophy
- © 2024 by American Journal of Neuroradiology