<sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the Results
Brain positron emission tomography imaging with 18Fluorine-fluorodeoxyglucose (FDG-PET) has demonstrated utility in suspected autoimmune encephalitis. Visual and/or assisted image reading is not well established to evaluate hypometabolism/hypermetabolism. We retrospectively evaluated patients with a...
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doaj-6628c4c2ce774f9abebe1bc744e500b52020-11-25T02:53:45ZengMDPI AGDiagnostics2075-44182020-05-011035635610.3390/diagnostics10060356<sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the ResultsDavid Moreno-Ajona0Elena Prieto1Fabiana Grisanti2Inés Esparragosa3Lizeth Sánchez Orduz4Jaime Gállego Pérez-Larraya5Javier Arbizu6Mario Riverol7Department of Neurology, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainDepartment of Nuclear Medicine, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainDepartment of Nuclear Medicine, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainDepartment of Neurology, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainDepartment of Nuclear Medicine, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainDepartment of Neurology, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainDepartment of Nuclear Medicine, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainDepartment of Neurology, Clínica Universidad de Navarra, Pío XII 36, 31008 Pamplona, SpainBrain positron emission tomography imaging with 18Fluorine-fluorodeoxyglucose (FDG-PET) has demonstrated utility in suspected autoimmune encephalitis. Visual and/or assisted image reading is not well established to evaluate hypometabolism/hypermetabolism. We retrospectively evaluated patients with autoimmune encephalitis between 2003 and 2018. Patients underwent EEG, brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) sampling and autoantibodies testing. Individual FDG-PET images were evaluated by standard visual reading and assisted by voxel-based analyses, compared to a normal database. For the latter, three different methods were performed: two based on statistical surface projections (Siemens syngo.via Database Comparison, and 3D-SSP Neurostat) and one based on statistical parametric mapping (SPM12). Hypometabolic and hypermetabolic findings were grouped to identify specific patterns. We found six cases with definite diagnosis of autoimmune encephalitis. Two cases had anti-LGI1, one had anti-NMDA-R and two anti-CASPR2 antibodies, and one was seronegative. <sup>18</sup>F-FDG-PET metabolic abnormalities were present in all cases, regardless of the method of analysis. Medial–temporal and extra-limbic hypermetabolism were more clearly depicted by voxel-based analyses. We found autoantibody-specific patterns in line with the literature. Statistical surface projection (SSP) methods (Neurostat and syngo.via Database Comparison) were more sensitive and localized larger hypermetabolic areas. As it may lead to comparable and accurate results, visual analysis of FDG-PET studies for the diagnosis of autoimmune encephalitis benefits from voxel-based analysis, beyond the approach based on MRI, CSF sample and EEG.https://www.mdpi.com/2075-4418/10/6/356<sup>18</sup>F-FDG-PETvoxel-based analysisassisted analysisautoimmune encephalitislimbic encephalitis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David Moreno-Ajona Elena Prieto Fabiana Grisanti Inés Esparragosa Lizeth Sánchez Orduz Jaime Gállego Pérez-Larraya Javier Arbizu Mario Riverol |
spellingShingle |
David Moreno-Ajona Elena Prieto Fabiana Grisanti Inés Esparragosa Lizeth Sánchez Orduz Jaime Gállego Pérez-Larraya Javier Arbizu Mario Riverol <sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the Results Diagnostics <sup>18</sup>F-FDG-PET voxel-based analysis assisted analysis autoimmune encephalitis limbic encephalitis |
author_facet |
David Moreno-Ajona Elena Prieto Fabiana Grisanti Inés Esparragosa Lizeth Sánchez Orduz Jaime Gállego Pérez-Larraya Javier Arbizu Mario Riverol |
author_sort |
David Moreno-Ajona |
title |
<sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the Results |
title_short |
<sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the Results |
title_full |
<sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the Results |
title_fullStr |
<sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the Results |
title_full_unstemmed |
<sup>18</sup>F-FDG-PET Imaging Patterns in Autoimmune Encephalitis: Impact of Image Analysis on the Results |
title_sort |
<sup>18</sup>f-fdg-pet imaging patterns in autoimmune encephalitis: impact of image analysis on the results |
publisher |
MDPI AG |
series |
Diagnostics |
issn |
2075-4418 |
publishDate |
2020-05-01 |
description |
Brain positron emission tomography imaging with 18Fluorine-fluorodeoxyglucose (FDG-PET) has demonstrated utility in suspected autoimmune encephalitis. Visual and/or assisted image reading is not well established to evaluate hypometabolism/hypermetabolism. We retrospectively evaluated patients with autoimmune encephalitis between 2003 and 2018. Patients underwent EEG, brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) sampling and autoantibodies testing. Individual FDG-PET images were evaluated by standard visual reading and assisted by voxel-based analyses, compared to a normal database. For the latter, three different methods were performed: two based on statistical surface projections (Siemens syngo.via Database Comparison, and 3D-SSP Neurostat) and one based on statistical parametric mapping (SPM12). Hypometabolic and hypermetabolic findings were grouped to identify specific patterns. We found six cases with definite diagnosis of autoimmune encephalitis. Two cases had anti-LGI1, one had anti-NMDA-R and two anti-CASPR2 antibodies, and one was seronegative. <sup>18</sup>F-FDG-PET metabolic abnormalities were present in all cases, regardless of the method of analysis. Medial–temporal and extra-limbic hypermetabolism were more clearly depicted by voxel-based analyses. We found autoantibody-specific patterns in line with the literature. Statistical surface projection (SSP) methods (Neurostat and syngo.via Database Comparison) were more sensitive and localized larger hypermetabolic areas. As it may lead to comparable and accurate results, visual analysis of FDG-PET studies for the diagnosis of autoimmune encephalitis benefits from voxel-based analysis, beyond the approach based on MRI, CSF sample and EEG. |
topic |
<sup>18</sup>F-FDG-PET voxel-based analysis assisted analysis autoimmune encephalitis limbic encephalitis |
url |
https://www.mdpi.com/2075-4418/10/6/356 |
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