{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:16:13Z","timestamp":1790270173086,"version":"4.1.0"},"reference-count":181,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Parkinson\u2019s disease (PD) is a multifaceted neurodegenerative disorder characterized by dopaminergic neuronal loss and widespread \u03b1-synuclein pathology. Nuclear medicine imaging offers essential in vivo tools for early diagnosis, differential assessment, and monitoring disease progression. This review summarizes key PET and SPECT radiotracers targeting dopaminergic synthesis and transport, vesicular storage, post-synaptic receptors, neuroinflammation, and protein aggregation, highlighting their roles in clinical evaluation and phenotyping. Clinically, these modalities support earlier recognition of PD, distinction from atypical parkinsonian syndromes, and assessment of non-motor involvement. Future directions include the development of selective \u03b1-synuclein tracers and multimodal imaging strategies to refine prodromal detection and guide personalized therapeutic interventions.<\/jats:p>","DOI":"10.3390\/medsci13040308","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:17:36Z","timestamp":1765185456000},"page":"308","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Nuclear Medicine Imaging Biomarkers in Parkinson\u2019s Disease: Past, Present, and Future Directions"],"prefix":"10.3390","volume":"13","author":[{"given":"Anna Lisa","family":"Martini","sequence":"first","affiliation":[{"name":"Unit of Nuclear Medicine, Department of Diagnostic Imaging, N.O.P.\u2014S. Stefano, U.S.L. Toscana Centro, 59100 Prato, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stelvio","family":"Sestini","sequence":"additional","affiliation":[{"name":"Unit of Nuclear Medicine, Department of Diagnostic Imaging, N.O.P.\u2014S. Stefano, U.S.L. Toscana Centro, 59100 Prato, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3841-1825","authenticated-orcid":false,"given":"Dinahlee Saturnino","family":"Guarino","sequence":"additional","affiliation":[{"name":"Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3707-018X","authenticated-orcid":false,"given":"Paola","family":"Feraco","sequence":"additional","affiliation":[{"name":"Centre for Medical Sciences (CISMed), University of Trento, 38122 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S1474-4422(21)00030-2","article-title":"Challenges in the diagnosis of Parkinson\u2019s disease","volume":"20","author":"Tolosa","year":"2021","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov. 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