2-[18F]-FDG PET for imaging brain involvement in patients with long COVID: perspective of the EANM Neuroimaging Committee

Verger, Antoine; Barthel, Henryk; Tolboom, Nelleke; Fraioli, Francesco; Cecchin, Diego; Albert, Nathalie L.; Berckel, Bart van; Boellaard, Ronald; Brendel, Matthias; Ekmekçioğlu, Özgül; Semah, Franck; Traub‐Weidinger, Tatjana; Weehaeghe, Donatienne Van; Morbelli, Silvia; Guedj, Éric

doi:10.1007/s00259-022-05913-7

Cited by 23 publications

(35 citation statements)

References 43 publications

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“…The imaging revealed abnormal findings in more than 66% of the individuals, most of whom presented frontoparietal hypometabolism (49). In conclusion, the 18F-FDG-PET data demonstrated above suggests that the frontal, temporal, and parietal lobes are sensitive to SARS-CoV-2 infection (45)(46)(47)(48)(49). Interestingly, Verger et al reported not only 18F-FDG-PET hypometabolism in cerebrum of patients with PCNS but also the demonstration of a brain impairment, and the differential diagnosis of PCNS in 18F-FDG-PET (47).…”

Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 74%

“…In conclusion, the 18F-FDG-PET data demonstrated above suggests that the frontal, temporal, and parietal lobes are sensitive to SARS-CoV-2 infection (45)(46)(47)(48)(49). Interestingly, Verger et al reported not only 18F-FDG-PET hypometabolism in cerebrum of patients with PCNS but also the demonstration of a brain impairment, and the differential diagnosis of PCNS in 18F-FDG-PET (47). The authors claims that an individual PET hypometabolism, suggesting network-based involvement, may indicate a real cerebrum impairment (47).…”

Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 77%

“…According to certain studies, patients with Post COVID-19, who have chronic functional problems, have 18F-FDG-PET hypometabolism in several cerebrum areas (45)(46)(47)(48). After analyzing the 18F-FDG cerebral PET of patients with PCNS, with a scientifically verified diagnosis of SARS-CoV-2 disease and chronic functional symptoms at least 3 weeks after the first infection, scientists discovered hypometabolism in: the bilateral orbital gyrus which contains the olfactory gyrus, the right parahippocampal gyrus, the right temporal lobe e.g., amygdala, hippocampus, and thalamus, the bilateral cerebellum and the bilateral pons/medulla brainstem (45-48) (Figures 2, 3).…”

Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 99%

“…After analyzing the 18F-FDG cerebral PET of patients with PCNS, with a scientifically verified diagnosis of SARS-CoV-2 disease and chronic functional symptoms at least 3 weeks after the first infection, scientists discovered hypometabolism in: the bilateral orbital gyrus which contains the olfactory gyrus, the right parahippocampal gyrus, the right temporal lobe e.g., amygdala, hippocampus, and thalamus, the bilateral cerebellum and the bilateral pons/medulla brainstem ( 45 – 48 ) ( Figures 2 , 3 ). Furthermore, this hypometabolism was linked to the patients' problems e.g., memory and cognitive dysfunction, sleep disturbances and pain ( 45 – 47 ). Moreover, a new research with 18F-FDG-PET demonstrated the neurological long-term consequences of COVID-19 ( 49 ).…”

Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 99%

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Imaging and neuropathological findings in patients with Post COVID-19 Neurological Syndrome—A review

et al. 2023

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Post COVID-19 syndrome is determined as signs and symptoms that appear during or after an infection consistent with SARS-CoV-2 disease, persist for more than 12 weeks and are not explained by an alternative diagnosis. This review presents the neuropathological findings and imaging findings in Post COVID-19 Neurological Syndrome: the focal point is on the manifestations of involvement evident on brain and spine imaging.

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Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 74%

Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 77%

Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 99%

Section: Which Radiological Features Can We Find In the Imaging Of Th...mentioning

confidence: 99%

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Imaging and neuropathological findings in patients with Post COVID-19 Neurological Syndrome—A review

et al. 2023

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“…Brain 18 F-FDG PET holds great promise to assess brain involvement in patients with post-COVID-19 conditions (PCC) and may help identify distinct prognoses and management strategies for these patients [1,2]. PCC is defined by the World Health Organization (WHO) as a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis [3].…”

Section: Introductionmentioning

confidence: 99%

Brain 18F-FDG PET imaging in outpatients with post-COVID-19 conditions: findings and associations with clinical characteristics

Goehringer

Bruyere

Doyen

et al. 2022

Eur J Nucl Med Mol Imaging

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Background Brain 18 F-FDG PET imaging has the potential to provide an objective assessment of brain involvement in post-COVID-19 conditions but previous studies of heterogeneous patient series yield inconsistent results. The current study aimed to investigate brain 18 F-FDG PET findings in a homogeneous series of outpatients with post-COVID-19 conditions and to identify associations with clinical patient characteristics. Methods We retrospectively included 28 consecutive outpatients who presented with post-COVID-19 conditions between September 2020 and May 2022 and who satisfied the WHO definition, and had a brain 18 F-FDG PET for suspected brain involvement but had not been hospitalized for COVID-19. A voxel-based group comparison with 28 age- and sex-matched healthy controls was performed (p-voxel at 0.005 uncorrected, p-cluster at 0.05 FWE corrected) and identified clusters were correlated with clinical characteristics. Results Outpatients with post-COVID-19 conditions exhibited diffuse hypometabolism predominantly involving right frontal and temporal lobes including the orbito-frontal cortex and internal temporal areas. Metabolism in these clusters was inversely correlated with the number of symptoms during the initial infection ( r = − 0.44, p = 0.02) and with the duration of symptoms ( r = − 0.39, p = 0.04). Asthenia and cardiovascular, digestive, and neurological disorders during the acute phase and asthenia and language disorders during the chronic phase ( p ≤ 0.04) were associated with these hypometabolic clusters. Conclusion Outpatients with post-COVID-19 conditions exhibited extensive hypometabolic right fronto-temporal clusters. Patients with more numerous symptoms during the initial phase and with a longer duration of symptoms were at higher risk of persistent brain involvement. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-022-06013-2.

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Distribution of insulin in primate brain following nose‐to‐brain transport

Smith,

Fan,

Marriner

et al. 2024

A&D Transl Res & Clin Interv

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IntroductionNose‐to‐brain (N2B) insulin delivery has potential for Alzheimer's disease (AD) therapy. However, clinical implementation has been challenging without methods to follow N2B delivery non‐invasively. Positron emission tomography (PET) was applied to measure F‐18‐labeled insulin ([18F]FB‐insulin) from intranasal dosing to brain uptake in non‐human primates following N2B delivery.Methods[18F]FB‐insulin was prepared by reacting A1,B29‐di(tert‐butyloxycarbonyl)insulin with [18F]‐N‐succinimidyl‐4‐fluorobenzoate. Three methods of N2B delivery for [18F]FB‐insulin were compared – delivery as aerosol via tubing (rhesus macaque, n = 2), as aerosol via preplaced catheter (rhesus macaque, n = 3), and as solution via preplaced catheter (cynomolgus macaque, n = 3). Following dosing, dynamic PET imaging (120 min) quantified delivery efficiency to the nasal cavity and whole brain. Area under the time‐activity curve was calculated for 46 regions of the cynomolgus macaque brain to determine regional [18F]FB‐insulin levels.ResultsLiquid instillation of [18F]FB‐insulin by catheter outperformed aerosol methods for delivery to the subject (39.89% injected dose vs 10.03% for aerosol via tubing, 0.17% for aerosol by catheter) and subsequently to brain (0.34% injected dose vs 0.00020% for aerosol via tubing, 0.05% for aerosol by catheter). [18F]FB‐insulin was rapidly transferred across the cribriform plate to limbic and frontotemporal areas responsible for emotional and memory processing. [18F]FB‐insulin half‐life was longer in olfactory nerve projection sites with high insulin receptor density compared to the whole brain.DiscussionThe catheter‐based liquid delivery approach combined with PET imaging successfully tracked the fate of N2B [18F]FB‐insulin and is thought to be broadly applicable for assessments of other therapeutic agents. This method can be rapidly applied in humans to advance clinical evaluation of N2B insulin as an AD therapeutic.Highlights for [18F]FB‐insulin passage across the cribriform plate was detected by PET. Intranasal [18F]FB‐insulin reached the brain within 13 min. [18F]FB‐insulin activity was highest in emotional and memory processing regions. Aerosol delivery was less efficient than liquid instillation by preplaced catheter. Insulin delivery to the cribriform plate was critical for arrival in the brain.

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2-[18F]-FDG PET for imaging brain involvement in patients with long COVID: perspective of the EANM Neuroimaging Committee

Cited by 23 publications

References 43 publications

Imaging and neuropathological findings in patients with Post COVID-19 Neurological Syndrome—A review

Imaging and neuropathological findings in patients with Post COVID-19 Neurological Syndrome—A review

Brain 18F-FDG PET imaging in outpatients with post-COVID-19 conditions: findings and associations with clinical characteristics

Distribution of insulin in primate brain following nose‐to‐brain transport

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