Sonja Kosek, Ellen Kilsved, Torsten Danfors, Janet L Cunningham, Radu Pavel, Anna Rostedt Punga, Joachim Burman, David Fällmar
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The resulting meta-analysis is complementary to previous publications with large or medium-sized cohorts.</p><p><strong>Patients and methods: </strong>The review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and aimed to identify all studies with at least 1 case of AIE in which brain FDG PET was performed. Results from MRI and FDG PET were extracted on a patient-by-patient basis.</p><p><strong>Results: </strong>The literature search yielded 1303 results, of which 234 studies were included, containing 498 cases. Abnormal FDG PET findings are reported in 93% compared with 55% with MRI. The affected brain regions, rates of unilateral versus bilateral findings, and hypermetabolism versus hypometabolism are descriptively presented in tables categorized according to the associated antibody.</p><p><strong>Conclusions: </strong>FDG PET detected abnormalities more frequently than MRI, particularly in cases with anti-NMDAR and anti-GABA-B antibodies. Findings include a high prevalence of hypermetabolism in the medial temporal lobes, but also a high prevalence of parietal and occipital hypometabolism. Results differed depending on the associated antibody. Overall, the findings strengthen the importance of FDG PET in patients with suspected AIE, and the antibody-related patterns of regional metabolic abnormalities indicate a high potential for further development as a diagnostic and prognostic tool.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"208-213"},"PeriodicalIF":9.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Regional Metabolic Abnormalities in Autoimmune Encephalitis: A Meta-analysis of 498 Cases With Brain FDG PET.\",\"authors\":\"Sonja Kosek, Ellen Kilsved, Torsten Danfors, Janet L Cunningham, Radu Pavel, Anna Rostedt Punga, Joachim Burman, David Fällmar\",\"doi\":\"10.1097/RLU.0000000000005574\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Autoimmune encephalitis (AIE) is a group of conditions that are insufficiently understood and difficult to diagnose. 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引用次数: 0
摘要
目的:自身免疫性脑炎(AIE)是一类认识不足、诊断困难的疾病。一些出版物指出,与核磁共振成像相比,FDG PET 具有更高的灵敏度。本研究旨在对出版物进行系统性回顾,以评估脑FDG正电子发射计算机断层显像与核磁共振成像结果在AIE个体水平上的特点和频率,包括病例报告和系列病例。由此产生的荟萃分析是对以前发表的大中型队列研究的补充:综述采用PRISMA(系统综述和荟萃分析的首选报告项目)指南进行,旨在确定所有至少有一例AIE病例且进行了脑FDG PET检查的研究。根据患者的具体情况提取 MRI 和 FDG PET 的结果:结果:文献检索共获得 1303 项结果,其中 234 项研究被纳入,包含 498 个病例。据报道,93%的 FDG PET 发现异常,而 MRI 为 55%。受影响的脑区、单侧与双侧发现的比例以及高代谢与低代谢的情况,根据相关抗体分类以表格形式描述:FDG正电子发射计算机断层显像比核磁共振成像更经常发现异常,尤其是在有抗NMDAR和抗GABA-B抗体的病例中。研究结果表明,颞叶内侧代谢亢进的发病率较高,顶叶和枕叶代谢亢进的发病率也很高。相关抗体不同,结果也不同。总之,研究结果加强了 FDG PET 在疑似 AIE 患者中的重要性,而与抗体相关的区域代谢异常模式表明,FDG PET 很有可能进一步发展成为一种诊断和预后工具。
Regional Metabolic Abnormalities in Autoimmune Encephalitis: A Meta-analysis of 498 Cases With Brain FDG PET.
Purpose: Autoimmune encephalitis (AIE) is a group of conditions that are insufficiently understood and difficult to diagnose. Several publications indicate that FDG PET has superior sensitivity compared with MRI. This study aimed to perform a systematic review of publications to assess the characteristics and frequency of brain FDG PET compared with MRI findings at the individual level in AIE, including case reports and case series. The resulting meta-analysis is complementary to previous publications with large or medium-sized cohorts.
Patients and methods: The review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and aimed to identify all studies with at least 1 case of AIE in which brain FDG PET was performed. Results from MRI and FDG PET were extracted on a patient-by-patient basis.
Results: The literature search yielded 1303 results, of which 234 studies were included, containing 498 cases. Abnormal FDG PET findings are reported in 93% compared with 55% with MRI. The affected brain regions, rates of unilateral versus bilateral findings, and hypermetabolism versus hypometabolism are descriptively presented in tables categorized according to the associated antibody.
Conclusions: FDG PET detected abnormalities more frequently than MRI, particularly in cases with anti-NMDAR and anti-GABA-B antibodies. Findings include a high prevalence of hypermetabolism in the medial temporal lobes, but also a high prevalence of parietal and occipital hypometabolism. Results differed depending on the associated antibody. Overall, the findings strengthen the importance of FDG PET in patients with suspected AIE, and the antibody-related patterns of regional metabolic abnormalities indicate a high potential for further development as a diagnostic and prognostic tool.
期刊介绍:
Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty.
Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.