Relevance of Brain 18F-FDG PET Imaging in Probable Seronegative Encephalitis With Catatonia: A Case Report.
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ABSTRACT:
SUBMITTER: Guetta M
PROVIDER: S-EPMC8219867 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Knowledge of the within-subject variability of 18F-FDG PET/MRI measurements is necessary for proper interpretation of quantitative PET or MRI metrics in the context of therapeutic efficacy assessments with integrated PET/MRI scanners. The goal of this study was to determine the test-retest repeatability of these metrics on PET/MRI, with comparison to similar metrics acquired by PET/CT. Methods: This prospective study enrolled subjects with pathology-proven pelvic malignancies. Baseline imaging consisted of PET/CT immediately followed by PET/MRI, using a single 370-MBq 18F-FDG dose. Repeat imaging was performed within 7 d using an identical imaging protocol, with no oncologic therapy between sessions. PET imaging on both scanners consisted of a list-mode acquisition at a single pelvic station. The MRI consisted of 2-point Dixon imaging for attenuation correction, standard sequences for anatomic correlation, and diffusion-weighted imaging. PET data were statically reconstructed using various frame durations and minimizing uptake time differences between sessions. SUV metrics were extracted for both PET/CT and PET/MRI in each imaging session. Apparent diffusion coefficient (ADC) metrics were extracted for both PET/MRI sessions. Results: The study cohort consisted of 14 subjects (13 female, 1 male) with various pelvic cancers (11 cervical, 2 rectal, 1 endometrial). For SUVmax, the within-subject coefficient of variation (wCV) appeared higher for PET/CT (8.5%-12.8%) than PET/MRI (6.6%-8.7%) across all PET reconstructions, though with no significant repeatability differences (all P values ≥ 0.08) between modalities. For lean body mass-adjusted SUVpeak, the wCVs appeared similar for PET/CT (9.9%-11.5%) and PET/MRI (9.2%-11.3%) across all PET reconstructions, again with no significant repeatability differences (all P values ≥ 0.14) between modalities. For PET/MRI, the wCV for ADCmedian of 3.5% appeared lower than the wCVs for SUVmax (6.6%-8.7%) and SULpeak (9.2%-11.3%), though without significant repeatability differences (all P values ≥ 0.23). Conclusion: For solid tumors of the pelvis, the repeatability of the evaluated SUV and ADC metrics on 18F-FDG PET/MRI is both acceptably high and similar to previously published values for 18F-FDG PET/CT and MRI, supporting the use of 18F-FDG PET/MRI for quantitative oncologic treatment response assessments.
| S-EPMC6681694 | biostudies-literature
Project description:Choriocarcinoma is an exceptionally aggressive trophoblastic cell tumor that that typically originates in gonadal tissues, with rare occurrences outside the gonads, including the mediastinum, retroperitoneum, and intracranial sites. However, it rarely occurs in the stomach. Herein, we presented a case of primary gastric choriocarcinoma in a 27-year-old female patient who found multiple liver masses detected during physical examination, accompanied by remarkably elevated human chorionic gonadotropin levels. The 18F-FDG PET/CT scan suggested ring-shaped intense uptake masses located in the gastric sinus and liver, and no significance in the pelvic region. Final histopathology indicated primary choriocarcinoma of the stomach. This case illustrates that 18F-FDG PET/CT is an essential imaging technique for the clinical diagnosis and stage of primary choriocarcinoma.
| S-EPMC10666916 | biostudies-literature
Project description:Purpose: The metabolic patterns of 18F-fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG-PET) in autoimmune encephalitis associated with leucine-rich glioma-inactivated 1 antibody (LGI1 AE) are still unclear. We performed a cohort study to investigate the clinical metabolic characteristics and diagnostic value based on 18F-FDG-PET in patients with LGI1 AE. Materials and Methods: A total of 34 patients including 18 patients (53%) in the acute phase and 16 patients (47%) in the chronic phase who were diagnosed with LGI1 AE were retrospectively analyzed from October 2014 to June 2018 at the Department of Neurology in Beijing Tiantan Hospital, the Capital Medical University. The clinical data were collected by searching through electronic medical records. Results: The initial 18F-FDG-PET scan indicated a significant abnormal metabolic pattern in 31 LGI1 AE patients (91%), whereas only 20 patients (59%) showed an abnormal MRI signal (P < 0.05). The 18F-FDG-PET metabolic pattern was reversible after treatment; most of the patients showed an almost normal uptake of 18F-FDG-PET after discharge. Regarding the spatial distribution, the abnormal metabolic pattern in LGI1 AE subjects exhibiting hypermetabolism was specifically located in the basal ganglia (BG) and medial temporal lobe (MTL). BG hypermetabolism was observed in 28 subjects (82%), and 68% of patients showed MTL hypermetabolism. A total of 17 patients (50%) exhibited faciobrachial dystonic seizures (FBDS), and the remaining subjects showed non-FBDS symptoms (50 and 50%). BG-only hypermetabolism was detected in seven subjects in the FBDS subgroup (7/16) but in only one subject in the non-FBDS subgroup (1/15) (44 vs. 7%, P < 0.05). Conclusion: 18F-FDG-PET imaging was more sensitive than MRI in the diagnosis of LGI1 AE. Isolated BG hypermetabolism was more frequently observed in subjects with FBDS, suggesting the potential involvement of the BG.
| S-EPMC7290050 | biostudies-literature
Project description:BackgroundThe clinical diagnosis of deep sternal wound infection (DSWI) is supported by imaging findings including 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT). To avoid misinterpretation due to normal post-surgery inflammation we assessed normal imaging findings in non-infected patients after sternotomy.MethodsThis is a prospective cohort study including non-infectious patients with sternotomy. All patients underwent 18F-FDG-PET/CT at either 5 weeks (group 1), 12 weeks (group 2) or 52 weeks (group 3) post-surgery. 18F-FDG uptake was scored visually in five categories and assessed quantitatively.ResultsA total of 44 patients were included. Sternal mean SUVmax was 7.34 (± 1.86), 5.22 (± 2.55) and 3.20 (± 1.80) in group 1, 2 and 3, respectively (p < 0.01). Sternal mean SUVmean was 3.84 (± 1.00), 2.69 (± 1.32) and 1.71 (± 0.98) in group 1, 2 and 3 (p < 0.01). All patients in group 1 had elevated uptake whereas group 2 and 3 showed 2/15 (13%) and 11/20 (55%) patients respectively with no elevated uptake. Group 3 still showed an elevated uptake pattern in in 9/20 (45%) and in 3/9 (33%) with a high-grade diffuse uptake pattern.ConclusionThis study shows significant lower sternal 18F-FDG at 55 weeks compared to 5 weeks post-sternotomy however elevated uptake patterns may persist.
| S-EPMC10261398 | biostudies-literature
Project description:In Mild Cognitive Impairment (MCI), the study of brain metabolism, provided by 18F-FluoroDeoxyGlucose Positron Emission Tomography (18F-FDG PET) can be integrated with brain perfusion through pseudo-Continuous Arterial Spin Labeling Magnetic Resonance sequences (MR pCASL). Cortical hypometabolism identification generally relies on wide control group datasets; pCASL control groups are instead not publicly available yet, due to lack of standardization in the acquisition parameters. This study presents a quantitative pipeline to be applied to PET and pCASL data to coherently analyze metabolism and perfusion inside 16 matching cortical regions of interest (ROIs) derived from the AAL3 atlas. The PET line is tuned on 36 MCI patients and 107 healthy control subjects, to agree in identifying hypometabolic regions with clinical reference methods (visual analysis supported by a vendor tool and Statistical Parametric Mapping, SPM, with two parametrizations here identified as SPM-A and SPM-B). The analysis was conducted for each ROI separately. The proposed PET analysis pipeline obtained accuracy 78 % and Cohen's к 60 % vs visual analysis, accuracy 79 % and Cohen's к 58 % vs SPM-A, accuracy 77 % and Cohen's к 54 % vs SPM-B. Cohen's к resulted not significantly different from SPM-A and SPM-B Cohen's к when assuming visual analysis as reference method (p-value 0.61 and 0.31 respectively). Considering SPM-A as reference method, Cohen's к is not significantly different from SPM-B Cohen's к as well (p-value = 1.00). The complete PET-pCASL pipeline was then preliminarily applied on 5 MCI patients and metabolism-perfusion regional correlations were assessed. The proposed approach can be considered as a promising tool for PET-pCASL joint analyses in MCI, even in the absence of a pCASL control group, to perform metabolism-perfusion regional correlation studies, and to assess and compare perfusion in hypometabolic or normo-metabolic areas.
| S-EPMC10755331 | biostudies-literature
Project description:BackgroundProstate tuberculosis is a common form of urogenital tuberculosis that occurs in men. Clinical and imaging manifestations of prostate tuberculosis are atypical, which often need to be differentiated from benign prostatic hyperplasia, a prostate malignant tumor, and a urinary tract infection. Although prostate-specific membrane antigen (PSMA) is considered a specific biomarker for prostate cancer, it is also found within tuberculosis tissues that may be stimulated by angiogenic factors. An abnormal PSMA uptake on positron emission tomography combined with computed tomography (PET/CT) should eliminate the possibility of tuberculosis.Case reportIn this study, we reported a case of a 51-year-old man with an elevated erythrocyte sedimentation rate (ESR) but a normal prostate-specific antigen (PSA) value. 2-Deoxy-2-[fluorine-18]-fluoro-D-glucose (18F-FDG) and [fluorine-18]-prostate-specific membrane antigen (18F-PSMA) PET/CT scans were performed for further evaluation. The prostate showed a high fluoro-D-glucose (FDG) uptake but a slight PSMA uptake. Multiple osteolytic bone destruction and lymph nodes with an increased FDG uptake but a mild PSMA uptake were observed throughout the body. Systemic tuberculosis was diagnosed based on the prostate biopsy and the positive result of the T-cell spot test regarding tuberculosis infection. After 6 months of standard anti-tuberculosis treatment, the patient experienced symptom relief.ConclusionIn the case of a urinary tract infection, where the prostate shows high FDG uptake lesions with perilesional abscess, a mildly increased PSMA uptake, a low PSA value, a high ESR, and relevant clinical symptoms, tuberculosis should be considered and laboratory tests are required, especially when symptoms are relieved after successful anti-tuberculosis therapy. The final confirmation of the diagnosis still relies on pathological examination.
| S-EPMC11349513 | biostudies-literature
Project description:AimAnti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a subgroup of treatable autoimmune encephalitis, characterized by rapid development of psychosis, cognitive impairments and seizures. Etiologically, anti-NMDAR encephalitis could be divided into three subgroups, which are paraneoplastic (especially associated with ovarian teratoma), viral encephalitis-related and cryptogenic. Each type is different in clinical course, treatment strategies and prognosis. In this study, we aim to investigate whether anti-NMDAR encephalitis patients with different trigger factors exhibit distinct cerebral metabolic patterns detected by 18F-fluorodeoxyglucose positron emission tomography imaging.Methods24 patients with anti-NMDAR encephalitis in acute phase from Huashan Hospital, Fudan University (Shanghai, China) were recruited in this study. Each patient was classified into one of etiological subgroups. Positron emission tomography images of individual patients were analyzed with both routine visual reading and computer-supported reading by comparison with those of the same 10 healthy controls using a voxel-wise statistical parametric mapping analysis.ResultsPatients in both the cryptogenic (13 patients) and paraneoplastic (five patients) subgroups showed hypermetabolism in the frontal-temporal lobes and basal ganglia, covarying with hypometabolism in the occipital regions. Notably, the abnormal metabolism was usually asymmetric in the cryptogenic subgroup, but relatively symmetric in the paraneoplastic subgroup. Moreover, the other six patients secondary to viral encephalitis presented with significant hypometabolism in the bilateral occipital regions, as well as in the unilateral temporal lobes and part of basal ganglia (also is virus infection side), but hypermetabolism in the contralateral temporal areas.ConclusionThis study revealed that patients with anti-NMDAR encephalitis triggered by different factors presented distinct cerebral metabolic patterns. Awareness of these patterns may help to better understand the varying occurrence and development of anti-NMDAR encephalitis in each subgroup, and could offer valuable information to the early diagnosis, treatment and prognosis of this disorder.Trial registration numberChiCTR2000029115 (Chinese clinical trial registry site, http://www.chictr.org).
| S-EPMC7919218 | biostudies-literature
Project description:BackgroundIdiopathic normal pressure hydrocephalus (iNPH) is an important and treatable cause of neurologic impairment. Diagnosis is complicated due to symptoms overlapping with other age related disorders. The pathophysiology underlying iNPH is not well understood. We explored FDG-PET abnormalities in iNPH patients in order to determine if FDG-PET may serve as a biomarker to differentiate iNPH from common neurodegenerative disorders.MethodsWe retrospectively compared 18F-FDG PET-CT imaging patterns from seven iNPH patients (mean age 74 ± 6 years) to age and sex matched controls, as well as patients diagnosed with clinical Alzheimer's disease dementia (AD), Dementia with Lewy Bodies (DLB) and Parkinson's Disease Dementia (PDD), and behavioral variant frontotemporal dementia (bvFTD). Partial volume corrected and uncorrected images were reviewed separately.ResultsPatients with iNPH, when compared to controls, AD, DLB/PDD, and bvFTD, had significant regional hypometabolism in the dorsal striatum, involving the caudate and putamen bilaterally. These results remained highly significant after partial volume correction.ConclusionsIn this study, we report a FDG-PET pattern of hypometabolism in iNPH involving the caudate and putamen with preserved cortical metabolism. This pattern may differentiate iNPH from degenerative diseases and has the potential to serve as a biomarker for iNPH in future studies. These findings also further our understanding of the pathophysiology underlying the iNPH clinical presentation.
| S-EPMC5987871 | biostudies-literature
Project description:Contributions of glial cells to neuroenergetics have been the focus of extensive debate. Here we provide positron emission tomography evidence that activation of astrocytic glutamate transport via the excitatory amino acid transporter GLT-1 triggers widespread but graded glucose uptake in the rodent brain. Our results highlight the need for a reevaluation of the interpretation of [18F]FDG positron emission tomography data, whereby astrocytes would be recognized as contributing to the [18F]FDG signal.
| S-EPMC5378483 | biostudies-literature
Project description:Knowledge of the intrinsic variability of radiomic features is essential to the proper interpretation of changes in these features over time. The primary aim of this study was to assess the test-retest repeatability of radiomic features extracted from 18F-FDG PET images of cervical tumors. The impact of different image preprocessing methods was also explored. Methods: Patients with cervical cancer underwent baseline and repeat 18F-FDG PET/CT imaging within 7 d. PET images were reconstructed using 2 methods: ordered-subset expectation maximization (PETOSEM) or ordered-subset expectation maximization with point-spread function (PETPSF). Tumors were segmented to produce whole-tumor volumes of interest (VOIWT) and 40% isocontours (VOI40). Voxels were either left at the default size or resampled to 3-mm isotropic voxels. SUV was discretized to a fixed number of bins (32, 64, or 128). Radiomic features were extracted from both VOIs, and repeatability was then assessed using the Lin concordance correlation coefficient (CCC). Results: Eleven patients were enrolled and completed the test-retest PET/CT imaging protocol. Shape, neighborhood gray-level difference matrix, and gray-level cooccurrence matrix features were repeatable, with a mean CCC value of 0.81. Radiomic features extracted from PETOSEM images showed significantly better repeatability than features extracted from PETPSF images (P < 0.001). Radiomic features extracted from VOI40 were more repeatable than features extracted from VOIWT (P < 0.001). For most features (78.4%), a change in bin number or voxel size resulted in less than a 10% change in feature value. All gray-level emphasis and gray-level run emphasis features showed poor repeatability (CCC values < 0.52) when extracted from VOIWT but were highly repeatable (mean CCC values > 0.96) when extracted from VOI40 Conclusion: Shape, gray-level cooccurrence matrix, and neighborhood gray-level difference matrix radiomic features were consistently repeatable, whereas gray-level run length matrix and gray-level zone length matrix features were highly variable. Radiomic features extracted from VOI40 were more repeatable than features extracted from VOIWT Changes in voxel size or SUV discretization parameters typically resulted in relatively small differences in feature value, though several features were highly sensitive to these changes.
| S-EPMC8844259 | biostudies-literature