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Imaging of metabolism and blood flow in dementia (MRI/PET) 18 May 2015

There is no single diagnostic test or biomarker to definitively diagnose dementia and its underlying neurodegenerative disorder. The differential diagnosis between dementia and more treatable conditions may be problematic. Differentiation between the several neurodegenerative disorders is often difficult, especially in a young dementia population in which atypical presentations prevail.

More accurate diagnosis can be obtained by metabolic brain imaging, such as fluorodeoxyglucose (FDG) positron emission tomography (PET). Arterial spin labeling (ASL) is a non-invasive MR imaging technique that measures brain perfusion. ASL has clear advantages over PET: patient burden and costs are much lower and availability of MRI is much wider. Crucially, ASL can easily be added to the routinely performed structural MRI examination.

Feasibility studies show that ASL provides reliable perfusion maps in dementia. In patients with established Alzheimer’s disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with FDG-PET.

Learning objectives:
• To know the added value of metabolic/perfusion imaging for the diagnostic work-up of patients with suspected dementia
• To know the imaging abnormalities related to common neurodegenerative disorders underlying dementia with metabolic/perfusion imaging
• To know the theoretical background and recommended implementation of ASL for clinical applications

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Duration:37 mins

Speaker info

Marion Smits

Associate Professor of Neuroradiology, Erasmus University, Rotterdam Marion Smits is Associate Professor of Neuroradiology and combines her clinical work as a Neuroradiologist with scientific research into advanced MR neuroimaging, such as functional MRI, diffusion tensor imaging (DTI) and perfusion imaging. She uses these techniques to visualise the brain’s function and microstructure, and to study pathophysiological and regenerative processes in a variety of neurological diseases, such as stroke, dementia and brain tumours. Marion combines her clinical expertise with scientific research and active participation in key European organisations, including the European Society of Radiology (ESR), the European Society of Neuroradiology (ESNR), the European Society for Magnetic Resonance in Medicine and Biology (ESMRMB), and the European Organisation for Research and Treatment of Cancer (EORTC). Through her current research and position in the European COST-AID action BM1103 Arterial Spin Labeling (ASL) in dementia, she works towards translating this perfusion technique from the research arena to clinical practice. Her work has contributed to a recent white paper on recommendations for clinical implementation of ASL. As a permanent faculty member of several European and national course organisations she lectures frequently on advanced MR neuroimaging. She is Course Director of the European School of MRI fMRI & DTI course, and Scientific Programme 6 Committee Chair of the ESMRMB scientific annual meeting 2015 in Edinburgh (UK). She has recently been elected as Congress President for the 2018 annual meeting of the ESNR. Full list of publications: LinkedIn: