Imaging techniques play a pivotal role in diagnosing and managing degenerative disorders such as those affecting the brain (Alzheimer and Parkinson’s disease) and the musculoskeletal system (osteoporosis and arthritis).
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Degenerative diseases
Nuclear medicine and brain disorders
In the last 30 to 40 years, going hand-in-hand with the global rise of life expectancy, neurodegenerative diseases of the brain affecting in particular elderly people have become increasingly burdensome for society. Alzheimer’s disease is the most common and most widely known of these disorders, as it both attacks the intellect and emotional well-being of its victims, potentially devastating their lives and that of their families.
Neurodegenerative diseases are very challenging to diagnose. Patients often show only subtle and unclear signs and symptoms and even the findings of diagnostic imaging are not always clear-cut. By the time the images show unmistakable signs of disease, patients often already display sufficient symptoms for a clear diagnosis.
Diagnostic imaging has played a variety of roles in the study of Alzheimer’s disease over the past four decades. Initially, computed tomography and, later, magnetic resonance imaging (MRI) were used to rule out other causes of dementia. More recently, a variety of imaging methods, including structural and functional MRI and positron emission tomography studies, have shown characteristic changes in the brains of patients with Alzheimer’s. However, no imaging technique can serve all purposes as each has its unique strengths and weaknesses.
Imaging has also an important role to play in research, as it helps address many scientific questions and provides insights into the effects of Alzheimer’s and its natural history. It is an established tool in drug discovery and increasingly required in clinical trials to test for drugs.
Nuclear medicine and disorders of the musculoskeletal system
Diagnostics using nuclear techniques are also relevant for diseases that attack the musculoskeletal system. The most common of these is osteoporosis, which is particularly frequent in women in the postmenopausal age. This disease is characterized by too little bone formation, excessive bone loss or a combination of both, leading to bone fragility and an increased risk of fractures of the hip, spine and wrist. X-ray methods can be used to measure bone density. The most accurate is dual-energy x-ray absorptiometry scanning, which detects small changes in a patient’s bone mass by comparing his or her bone density to that of healthy adults and adults of the same age.
