Download PDF
CC BY 4.0 · Nuklearmedizin
DOI: 10.1055/a-2566-1487
Original Article

The Status of Neuroimaging with SPECT and PET in Germany: Results from the 1st Survey on Nuclear Neuroimaging in Germany in 2023

Neurobildgebung mit SPECT und PET in Deutschland: Ergebnisse der 1. Umfrage zur nuklearmedizinischen Neurobildgebung in Deutschland 2023
Ralph Buchert  ‡
1   Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Alexander Drzezga‡
2   Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany
3   Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
4   German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
,
Mathias Schreckenberger
5   Department of Nuclear Medicine, Johannes Gutenberg University, Mainz, Germany
,
Karl Josef Langen
6   Institute of Neuroscience and Medicine (INM-3/INM-4/INM-5/INM-11), Forschungszentrum Jülich, Jülich, Germany
7   Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
8   Center of Integrated Oncology, Aachen Bonn Cologne Düsseldorf, Germany
,
Philipp T Meyer
9   Department of Nuclear Medicine, Medical Center – University of Freiburg, Freiburg, Germany
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Summary

The advent of disease-modifying therapies for neurodegenerative diseases may result in a growing demand for nuclear neuroimaging procedures presenting opportunities but also challenges to the nuclear medicine community. Whether capacity and expertise in Germany are sufficient to meet an increasing demand for nuclear neuroimaging is under discussion. Against this background, the Neuroimaging Working Group of the German Society of Nuclear Medicine initiated the first survey on the status of nuclear neuroimaging in Germany in 2023.
82 institutions participated in the survey: 33 practices, 15 community hospitals, 34 university hospitals. Primary findings were the following. In practices, brain scans are less frequently performed than in hospitals and are often limited to dopamine transporter SPECT. Brain PET is mainly performed in hospitals, and in community hospitals it is often restricted to FDG PET. Nevertheless, availability of amyloid PET with well-certified quality can be taken for granted. Thus, access to amyloid PET will not be a major bottleneck for new treatments of Alzheimer’s disease. Adequate reimbursement and clear anchoring in clinical guidelines have the greatest potential to advance nuclear neuroimaging in Germany. Clinical dopamine transporter SPECT is largely in agreement with procedure guidelines. An area for improvement is the limited availability of MR images to avoid misinterpretation of structural/vascular lesions as nigrostriatal degeneration.
The survey provides the first systematic assessment of the status of nuclear neuroimaging in Germany. It underscores the capacity of the German nuclear medicine community to meet an increasing demand for neuroimaging procedures, its adherence to procedure guidelines and identifies topics for improvement.

Keywords

nuclear imaging - brain - SPECT - PET - Germany - survey

Supplementary Material



Publication History

Received: 16 March 2025

Accepted: 24 March 2025

Article published online:
15 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Sarazin M, Lagarde J, El I Haddad. et al. The path to next-generation disease-modifying immunomodulatory combination therapies in Alzheimerʼs disease. Nat Aging 2024;
    CrossrefPubMedSearch in Google Scholar
  • 2 Oertel WH, Janzen A, Henrich MT. et al. Acetyl-DL-leucine in two individuals with REM sleep behavior disorder improves symptoms, reverses loss of striatal dopamine-transporter binding and stabilizes pathological metabolic brain pattern-case reports. Nat Commun 2024; 15: 7619
    CrossrefPubMedSearch in Google Scholar
  • 3 Deutsche Gesellschaft für Neurologie e.V. Einfache modifizierte Aminosäure stoppte das Auftreten der Parkinson-Krankheit im Vorstadium. 2024 https://dgn.org/artikel/sensationelle-beobachtung-modifizierte-aminosaure-stoppte-parkinson-krankheit-im-vorstadium
    Search in Google Scholar
  • 4 DGN e.V. & DGPPN e.V. (eds.). S3-Leitlinie Demenzen, Version 4.0. 08.11.2023.
  • 5 Höglinger G, Trenkwalder C et al. (Hrsg.). Parkinson-Krankheit, S2k-Leitlinie. Leitlinien für Diagnostik und Therapie in der Neurologie. 2023
    Search in Google Scholar
  • 6 Garibotto V, Albert NL, Barthel H. et al. The approval of a disease-modifying treatment for Alzheimerʼs disease: impact and consequences for the nuclear medicine community. Eur J Nucl Med Mol Imaging 2021; 48: 3033-3036
    CrossrefPubMedSearch in Google Scholar
  • 7 Verger A, Yakushev I, Albert NL. et al. FDA approval of lecanemab: the real start of widespread amyloid PET use? – the EANM Neuroimaging Committee perspective. Eur J Nucl Med Mol Imaging 2023; 50: 1553-1555
    CrossrefPubMedSearch in Google Scholar
  • 8 Yakushev I, Verger A, Brendel M. et al. Lecanemab approval in EU: what should we be ready for?- the EANM perspective. Eur J Nucl Med Mol Imaging 2025;
    CrossrefPubMedSearch in Google Scholar
  • 9 Buchert R, Drzezga A, Schreckenberger M. et al. Capacity for brain amyloid PET in Germany: Results from the 1st Survey on Nuclear Brain Imaging in Germany. Eur J Nucl Med Mol Imaging, published online 27 March 2025.
    Crossref
  • 10 Lindner O, Schaefer WM, Silber S. et al. Myocardial Perfusion SPECT and ATTR imaging 2021 in Germany: Results of the 9th Survey. Nuklearmed-Nucl Med 2023; 62: 235-243
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Baradaran-Salimi K, Karimzadeh A, Voges B. et al. Brain perfusion SPECT in the presurgical evaluation of epilepsy: is additional ictal SPECT required in case of high-confidence lateralization of the seizure onset zone by interictal SPECT and vice versa?. EJNMMI Res 2024; 14: 83
    CrossrefPubMedSearch in Google Scholar
  • 12 Albert NL, Galldiks N, Ellingson BM. et al. PET-based response assessment criteria for diffuse gliomas (PET RANO 1.0): a report of the RANO group. Lancet Oncol 2024; 25: e29-e41
    CrossrefPubMedSearch in Google Scholar
  • 13 Canadaʼs Drug Agency CDA-AMC. Health Technology Review: Health System Readiness for Disease-Modifying Therapies for Alzheimer Disease. Canadian Journal of Health Technologies 2024; 4
    CrossrefSearch in Google Scholar
  • 14 Fendler W, Holzgreve A. PET in Deutschland 2021 – Eine Umfrage der Deutschen Gesellschaft für Nuklearmedizin und des Berufsverbandes Deutscher Nuklearmediziner. Submitted.
  • 15 Teipel SJ, Spottke A, Boecker H. et al. Patient-related benefits of amyloid PET imaging in dementia: Rationale and design of the German randomized coverage with evidence development study ENABLE. Alzh Dement-Trci 2023; 9: e12383
    CrossrefPubMedSearch in Google Scholar
  • 16 Kameyama M. Is Permeability Surface Area Product of [(18)F]Florbetaben Comparable to That of H(2)O?. J Nucl Med 2024; 65: 992
    CrossrefPubMedSearch in Google Scholar
  • 17 Levin F, Ferreira D, Lange C. et al. Data-driven FDG-PET subtypes of Alzheimerʼs disease-related neurodegeneration. Alzheimers Res Ther 2021; 13: 49
    CrossrefPubMedSearch in Google Scholar
  • 18 Ward J, Ly M, Raji CA. Brain PET Imaging Frontotemporal Dementia. Pet Clin 2023; 18: 123-133
    CrossrefPubMedSearch in Google Scholar
  • 19 Hu WT, Wang Z, Lee VMY. et al. Distinct cerebral perfusion patterns in FTLD and AD. Neurology 2010; 75: 881-888
    CrossrefPubMedSearch in Google Scholar
  • 20 Fujimi K, Sasaki K, Noda K. et al. Clinicopathological outline of dementia with Lewy bodies applying the revised criteria: the Hisayama study. Brain Pathol 2008; 18: 317-325
    CrossrefPubMedSearch in Google Scholar
  • 21 Hogan DB, Fiest KM, Roberts JI. et al. The Prevalence and Incidence of Dementia with Lewy Bodies: a Systematic Review. Can J Neurol Sci 2016; 43 (Suppl. 1) S83-S95
    CrossrefPubMedSearch in Google Scholar
  • 22 Morbelli S, Esposito G, Arbizu J. et al. EANM practice guideline/SNMMI procedure standard for dopaminergic imaging in Parkinsonian syndromes 1.0. Eur J Nucl Med Mol Imaging 2020; 47: 1885-1912
    CrossrefPubMedSearch in Google Scholar
  • 23 Tatsch K, Buchert R, Bartenstein P. et al. Dopamine Transporter SPECT with I-123 labelled FP-CIT (DaTSCANTM). Nuklearmedizin 2019; 58: 5-16
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Buchert R, Szabo B, Kovacs A. et al. Dopamine Transporter SPECT with 12-Minute Scan Duration Using Multiple-Pinhole Collimators. J Nucl Med 2024; 65: 446-452
    CrossrefPubMedSearch in Google Scholar
  • 25 Schiebler T, Apostolova I, Mathies FL. et al. No impact of attenuation and scatter correction on the interpretation of dopamine transporter SPECT in patients with clinically uncertain parkinsonian syndrome. Eur J Nucl Med Mol Imaging 2023; 50: 3302-3312
    CrossrefPubMedSearch in Google Scholar