18F-Flurodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) findings in children with encephalitis and comparison to conventional imaging

Turpin, Sophie; Martineau, Patrick; Levasseur, Marc-André; Meijer, Inge A.; Décarie, Jean‐Claude; Barsalou, Julie; Renaud, Christian; Decaluwe, Hélène; Haddad, Élie; Lambert, Raymond

doi:10.1007/s00259-019-04302-x

Cited by 28 publications

(84 citation statements)

References 36 publications

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“…PET abnormalities have also been demonstrated in paediatric AIE 22 and basal ganglia hypermetabolism has been reported in children with anti‐NMDAR encephalitis 6,23 . Majority show a combined pattern of hypo and hypermetabolism with basal ganglia hypermetabolism which is better appreciated with a quantitative rather than visual approach.…”

Section: Discussionmentioning

confidence: 99%

Metabolic scoring in autoimmune epilepsy—Should APE scores be modified?

et al. 2020

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To enable early initiation of appropriate therapy, a practical approach to the diagnosis of autoimmune encephalitis (AIE) has been suggested using conventional neurological evaluation, and standard diagnostic tests like magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) evaluation and electroencephalogram (EEG). 1 Further antibody results would substantiate the clinical diagnosis and can be

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Section: Discussionmentioning

confidence: 99%

Metabolic scoring in autoimmune epilepsy—Should APE scores be modified?

et al. 2020

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“…In the present study, we retrospectively evaluated a cohort of 73 patients with a diagnosis of DE regardless of their autoantibody status who underwent a complete clinical and paraclinical evaluation including 18 F-FDG PET/CT. To our knowledge, this is the largest study evaluating the cerebral metabolic pro le using 18 F-FDG PET/CT in this setting.…”

Section: Discussionmentioning

confidence: 99%

“…This metabolic gradient was more frequently affected than other paraclinical parameters evaluated. 18 F-FDG PET/CT with semi-quantitative analysis therefore appears to be an effective biomarker in DE.…”

Section: Discussionmentioning

confidence: 99%

“…18 F-Fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) could be a valuable biomarker of suspected DE [10,11]. While whole-body 18 F-FDG PET/CT is often performed to detect occult malignancies [12], brain 18 F-FDG PET/CT can also support the diagnosis of DE by providing information on synaptic activity. According to the currently available diagnostic criteria by Graus et al [5], three levels of evidence exist in the initial diagnosis workup, i.e., possible, probable and de nite DE.…”

Section: Introductionmentioning

confidence: 99%

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Decrease in the Cortex/striatum Metabolic Ratio on 18F-FDG PET: a Biomarker of Dysimmune Encephalitis

Leiris

Ruel

Vervandier

et al. 2021

Preprint

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Purpose: The aim was to determine the diagnostic value of the cortex/striatum metabolic ratio in 18F-FDG PET in a large cohort of patients suffering from dysimmune encephalitis (DE) and to search for clinical correlations with the course of the disease.Methods: We retrospectively collected complete clinical and paraclinical data of DE patients, including brain 18F-FDG PET/CT. Whole-brain statistical analysis was performed using SPM8 software after activity parametrization to the striatum and in comparison to healthy subjects. Conventional discriminant analysis between the DE group and controls was performed using cluster metabolic ratios. A correlation analysis between cluster metabolic ratios and clinical/paraclinical data was assessed.Results: Seventy-three patients with DE were included. In comparison to 44 controls, voxel-based statistical analysis identified one large cluster (p-voxel < 0.001 uncorrected; p-cluster<0.05, FWE corrected) of widespread decreased cortical metabolism relative to the striatum in DE patients. The mean parametrized cluster metabolic value was significantly lower for DE patients (1.06 ± 0.13) than for the control group (1.46 ± 0.08; p < 0.001). This cluster metabolic ratio correctly classified 97.4% of the individuals between patients with DE and healthy controls. Correlation analyses showed that a low cluster metabolic ratio was associated with higher risk of death (p = 0.04), the absence of autoantibodies (p = 0.05), and an increased delay between onset of symptoms and diagnostic (p = 0.01).Conclusion: The decrease in the cortex/striatal metabolic ratio has a good diagnostic performance for the differentiation of DE patients from controls and seems to provide prognostic information on the clinical course.

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“…Insurance barriers to care can also influence access to diagnostic testing. As an example, 18 F Fluorodeoxyglucose positron emission tomography (FDG-PET) has been emerging in the literature as having improved sensitivity, with abnormalities seen earlier on in the illness course (17)(18)(19). Access is dependent on the institution, and it has not yet been included in any proposed diagnostic criteria or assessment algorithms making efforts to obtain insurance prior authorizations particularly challenging.…”

Section: International Approaches To Assessment and Treatment Optionsmentioning

confidence: 99%

Developing Consensus in the Assessment and Treatment Pathways for Autoimmune Encephalitis in Child and Adolescent Psychiatry

et al. 2021

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Children with a diagnosis of Autoimmune Encephalitis (AE) frequently require multi-disciplinary care in order to mobilize the assessment and treatment necessary for recovery. Institutional and provider practice differences often influence the diagnostic workup and treatment pathways made available to patients. There are a variety of provider coalitions in pediatric rheumatology, internal medicine, and neurology that have been making meaningful progress toward the development of consensus in assessment and treatment approaches to patient care. However, child psychiatry is currently underrepresented in this work in spite of the high psychiatric symptom burden seen in some young patients. The need for consensus is often made visible only with inter-institutional dialogue regarding patient care trajectories. We aim to review key updates in the assessment and treatment of children and adolescents with autoimmune encephalitis during the acute phase, with or without catatonia, and to outline provider perspectives by comparing current treatment models in the United States, Canada, and Europe.

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18F-Flurodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) findings in children with encephalitis and comparison to conventional imaging

Cited by 28 publications

References 36 publications

Metabolic scoring in autoimmune epilepsy—Should APE scores be modified?

Metabolic scoring in autoimmune epilepsy—Should APE scores be modified?

Decrease in the Cortex/striatum Metabolic Ratio on 18F-FDG PET: a Biomarker of Dysimmune Encephalitis

Developing Consensus in the Assessment and Treatment Pathways for Autoimmune Encephalitis in Child and Adolescent Psychiatry

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