Dr Marcus Rault
MBBS FRCR FAANMS
Radiologist and Nuclear Medicine Specialist, Canopy Imaging I am a radiologist and nuclear medicine specialist working for both Canopy Imaging and HBDHB in the Hawke’s Bay region. I moved to New Zealand approximately 2 years ago after having worked in a consultant post in the Cardiff/South Wales region in the UK. I completed my training in radiology with a speciality focus in PET-CT and nuclear medicine in 2021 in Norwich withs specialty oncology/molecular imaging placements at Mount Vernon Hospital in London and at Addenbrooke’s Hospital in Cambridge.
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I have an interest in molecular imaging of the brain and have helped launch the PET-CT service locally in Hawke’s Bay including FDG brain imaging for dementia. My training and post training work in the UK involved FDG brain imaging as well as other neurological imaging including DaTSCAN and MRI. I also contribute to various oncology MDMs including ENT, breast, melanoma and colorectal locally as well as neuroendocrine tumour nationally. I am involved with New Zealand subgroup committees of both the AANMS and ANZSNM organisations.
Use of PET-CT in Dementia
This presentation highlights the pivotal role of FDG PET-CT in the modern assessment of dementia. Traditional imaging methods such as technetium-based HMPAO SPECT are now considered obsolete. Moreover, FDG PET-CT offers superior diagnostic accuracy compared to cross-sectional imaging alone, such as CT and MRI, particularly in early or ambiguous cases.
FDG PET-CT evaluates cerebral glucose metabolism, helping differentiate between Alzheimer’s disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). In AD, characteristic hypometabolism is seen in the bilateral temporal and parietal lobes, with sparing of primary sensory and subcortical structures. Quantitative analysis using z-scores enhances diagnostic precision.
The presentation also covers amyloid and tau imaging. Amyloid PET, supported by initiatives like the Centiloid project and AMYPAD, aids in early diagnosis, while tau imaging is emerging as a key prognostic tool, especially in predicting response to anti-amyloid therapies. FDA-approved anti-amyloid agents include Aducanumab, Lecanemab, and Donanemab.
FDG PET-CT is also valuable in Parkinson’s-plus syndromes and movement disorders. However, its use is limited in cases of delirium, psychiatric illness, or poorly controlled diabetes. Clinically, it supports diagnosis, treatment planning, and specialist referrals, with growing accessibility in New Zealand.
FDG PET-CT evaluates cerebral glucose metabolism, helping differentiate between Alzheimer’s disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). In AD, characteristic hypometabolism is seen in the bilateral temporal and parietal lobes, with sparing of primary sensory and subcortical structures. Quantitative analysis using z-scores enhances diagnostic precision.
The presentation also covers amyloid and tau imaging. Amyloid PET, supported by initiatives like the Centiloid project and AMYPAD, aids in early diagnosis, while tau imaging is emerging as a key prognostic tool, especially in predicting response to anti-amyloid therapies. FDA-approved anti-amyloid agents include Aducanumab, Lecanemab, and Donanemab.
FDG PET-CT is also valuable in Parkinson’s-plus syndromes and movement disorders. However, its use is limited in cases of delirium, psychiatric illness, or poorly controlled diabetes. Clinically, it supports diagnosis, treatment planning, and specialist referrals, with growing accessibility in New Zealand.