PHYSICIAN NEWSLETTERJune • 2017

This month, John P. Uglietta, M.D., Director of Neuroradiology at SimonMed Imaging, discusses the different cutting edge technologies offered at SimonMed for early diagnosis of Alzheimer’s disease and SimonMed’s major role in the New Frontier of Biomarker Imaging in Alzheimer’s disease through the IDEAS Trial (Imaging Dementia-Evidence for Amyloid Scanning).

3T MRI with NeuroQuantNeuroQuant is a fully automated quantitative brain imaging analysis software program that provides high-resolution 3D volumetric analysis of brain structures and compares them to a normal database of patients ranging in age from 3-100. NeuroQuant generates a color-coded 3D data set of anatomic brain structures along with graphic volumetric data reports of the patient’s brain structures

compared with age-matched controls. SimonMed’s team of experienced Neuroradiologists are using NeuroQuant routinely on all patients with a history of memory loss and possible Alzheimer’s disease. Together with the use of ultra high-field strength 3T MRI imaging, NeuroQuant allows SimonMed Neuroradiologists to detect early evidence of specific regions of brain atrophy such as the hippocampus which aids in early detection of Alzheimer’s disease and allows for serial quantitative measurements of the brain’s response to different treatments for dementia (Figures 1 and 2).

ALZHEIMER’S DISEASE

Figure 1: Coronal 3T MRI images show normal hippocampal volumes on left (arrows) and abnormal severe hippocampal atrophy on right in Alzheimer’s patient (arrows).

Figure 2: NeuroQuant Report in Alzheimer’s patient showing sever hippocampal atrophy (< 1%) and severely dilated ventricles and temporal horns (>99%).

Hippocampal Occupancy Score (HOC) 0.41

Brain Structure Volume (cm3 ) % of ICV(5%-95% Normative Percentile*) Normative Percentile*

Hippocampi 4.46 0.23 (0.32-0.46) < 1Lateral Ventricles 125.25 6.55 (1.85-4.98) > 99Inferior Lateral Ventricles 6.54 0.34 (0.13-0.29) 99

AGE-MATCHED REFERENCE CHARTS

Welcome to SimonMed’s physician newsletter. We hope this information can help you fully understand the scope of the programs and services we offer at our outpatient medical imaging facilities. We are committed to educating our physician partners on the excellent services for advanced imaging that we offer including a variety of medical services that play an integral role in the overall care of cancer patients.

Our highly qualified radiologists interpret exams performed on CT, MRI, ultrasound and nuclear medicine imaging at various locations throughout the Valley. We invite you to See Tomorrow, Today.

About the DoctorJohn P. Uglietta, M.D., Director of Neuroradiology at SimonMed Imaging, discusses the different cutting edge technologies offered at SimonMed for early diagnosis of Alzheimer’s disease and SimonMed’s major role in the New Frontier of Biomarker Imaging in Alzheimer’s disease through the IDEAS Trial (Imaging Dementia-Evidence for Amyloid Scanning).

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PET/CT brain imaging with FDGSimonMed offers PET/CT brain imaging with FDG. FDG is a radiopharmaceutical labeled with a glucose derivative which helps create a normal vs. abnormal map of brain function. NeuroQ is a powerful quantitative analysis tool that is used on all SimonMed FDG PET/CT brain scans which provides a unique color map overlay of abnormal brain regions compared with normal age-matched controls (Figure 3) which allows SimonMed Neuoradiologists to more accurately differentiate between different types of dementia such as Alzheimer’s disease, frontotemporal dementia, Lewy body dementia and multi-infarct dementia. NeuroQ analysis together with FDG PET/CT scanning allows for a more accurate and earlier diagnosis of Alzheimer’s disease and other dementias enabling initiation of earlier and more specific treatments for each dementia patient.

IDEAS Trial Using Amyvid and VizamylSimonMed is one the largest outpatient Imaging providers for the IDEAS study in the country and is the largest outpatient participant in the IDEAS study in Arizona offering seven different outpatient Neuro Degenerative Diagnostic Centers throughout the Valley and in Tucson for patient convenience. SimonMed is offering both F-18 Amyvid and F-18 Vizamyl PET/CT scanning of the brain which are both new

FDA-approved diagnostic PET radiotracers which bind to the Alzheimer’s biomarker beta-amyloid protein within neuritic plaques within the brain of Alzheimer’s patients. Direct beta-amyloid protein imaging in Alzheimer’s patients using Amyvid and Vizamyl PET/CT scanning is an exciting new diagnostic tool on the cutting edge of the New Frontier of biomarker-based imaging in the early diagnosis of Alzheimer’s disease. SimonMed Imaging is proud to be a major participant in the IDEAS study which has the potential to markedly change how we diagnose and treat early Alzheimer’s disease before irreversible brain degeneration and disability occurs (Figures 4 and 5).

SHARE YOUR FEEDBACKWe encourage you to provide feedback and we invite you to share any questions, concerns or topic suggestions to

John P. Uglietta, M.D., director of neuroradiology at SimonMed Imaging, at juglietta@simonmed.com.

Figure 3: FDG PET/CT with NeuroQ showing abnormal decreased metabolism in the temporal and parietal lobes (in red) in a pattern consistent with Alzheimer’s disease.

Figure 5: Vizamyl PET/CT showing normal brain on the left and abnormal Vizamyl uptake in the cortex of an Alzheimer’s brain on right.

Figure 4: Amyvid PET/CT showing normal brain on left and abnormal Amyvid uptake in the cortex of an Alzheimer’s brain on right.

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