Caspr2 antibody-associated limbic encephalitis: contribution of visual aided analysis of 18F-FDG PET images using normal database comparison

Publication date: Available online 13 February 2020Source: Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)Author(s): Liset Sánchez-Ordúz, Gállego Pérez-Larraya, Fabiana Grisanti, M. Centeno, Javier ArbizuAbstractEarly immunotherapy is of paramount importance for a positive outcome in patients suffering acute encephalitis of autoimmune origin (AIE). A new approach for early diagnosis based on clinical presentation and complementary tests has been proposed, but not all these tests may exhibit positive findings in the first weeks. While common forms of AIE (anti-LGI-1 and anti-NMDAR antibodies) exhibit consistent 18Fluor-fluorodeoxiglucose (FDG-PET) patterns in many cases, the anti-Caspr2 form of AIE is infrequent and FDG-PET patterns have not been well characterized. In our experience, FDG-PET in anti-Caspr2 limbic encephalitis shows medial temporal hypermetabolism and a diffuse cortical hypometabolism, even in the absence of findings in these tests. However, it is necessary to standardize the PET images analysis by means of visual and voxel-based methods compared to normal databases to define the areas of pathological metabolism that may be unnoticed when using visual analysis exclusively.ResumenUn inicio temprano de la inmunoterapia es fundamental para mejorar el pronóstico de los pacientes con encefalitis aguda de origen autoinmune (EAI). Se ha propuesto un nuevo abordaje clínico para el diagnóstico temprano basado en aspectos clínicos y pr...
Source: Revista Espanola de Medicina Nuclear e Imagen Molecular - Category: Nuclear Medicine Source Type: research