Case-Based Guide for Image Interpretation and Reporting

The brain is the most complex and intriguing part of the human body. Acceleration of neuroscience research and development over the last few decades has given us exciting new technologies to better understand brain function. Imaging modalities have become fundamental tools for the diagnosis and evaluation of brain pathologies, with molecular imaging offering the possibility to image and quantify brain function “in vivo.” However, functional imaging interpretation can be challenging and requires appropriate training. Single-photon emission tomography (SPECT) and positron emission tomography (PET) possess a lower spatial resolution compared to anatomic imaging methods such as magnetic resonance imaging (MRI). In addition, the introduction of hybrid technologies, which can provide correlative anatomic imaging via CT or MRI into the functional studies, requires additional training. The intent of this chapter is to provide a rational guide for molecular brain imaging interpretation, which is suitable for all levels of expertise. The content includes a teaching directory with fundamental knowledge, and a tutorial for systematic imaging analysis based on visual assessment as well as semiquantitative analysis. Suggestions for how to adequately report studies in each molecular imaging modality will be presented in a case mode. Clinical situations where molecular imaging can aid in the diagnosis of different neurodegenerative pathologies will be discussed.