Professional development and research are being neglected: a commentary on the 2019 RCR radiologists’ supporting professional activities (SPA) survey

When the National Health Service (NHS) acquired a statutory duty of care for quality in 1998, clinical governance became a mandatory and intrinsic part of modern medicine. Defined as “a framework through which NHS organisations are accountable for continuously improving the quality of their services and safe-guarding high standards of care by creating an environment in which excellence in clinical care will flourish”,1 the vehicle for NHS consultants to enact clinical governance was supporting professional activity (SPA). All activities that underpin direct clinical care (DCC) are encouraged during SPA time, including professional development, research, audit, teaching, clinical management, appraisal, and job planning.2,3 Adequate time for SPAs alongside DCC is therefore crucial for NHS consultants to\ud maintain excellence in clinical care.3 The recently published Royal College of Radiologists (RCR) Survey on Radiologists’ SPA4 has demonstrated three recurring themes, which are widely recognised to be growing concerns for our specialty

New Developments in Cholinergic Imaging in Alzheimer and Lewy Body Disorders

© 2020, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply. Purpose of Review: This paper aims to review novel trends in cholinergic neuroimaging in Alzheimer and Lewy body parkinsonian disorders. Recent Findings: The spectrum of cholinergic imaging is expanding with the availability of spatially more precise radioligands that allow assessment of previously less recognized subcortical and cortical structures with more dense cholinergic innervation. In addition, advances in MRI techniques now allow quantitative structural or functional assessment of both the cholinergic forebrain and the pedunculopontine nucleus, which may serve as non-invasive prognostic predictors. Multimodal imaging approaches, such as PET-MRI or multiligand PET, offer new insights into the dynamic and interactive roles of the cholinergic system at both local and larger-scale neural network levels. Summary: Our understanding of the heterogeneous roles of the cholinergic system in age-related diseases is evolving. Multimodal imaging approaches that provide complimentary views of the cholinergic system will be necessary to shed light on the impact of cholinergic degeneration on regional and large-scale neural networks that underpin clinical symptom manifestation in neurodegeneration