Nuclear Medicine Department, Grenoble Alpes University Hospital, Grenoble, France.
Laboratoire Radiopharmaceutiques Biocliniques, INSERM, Univ. Grenoble Alpes, 38000, Grenoble, France.
Eur J Nucl Med Mol Imaging. 2022 Feb;49(3):921-931. doi: 10.1007/s00259-021-05507-9. Epub 2021 Aug 31.
The aim of this [F]-FDG PET study was to determine the diagnostic value of the cortex/striatum metabolic ratio in a large cohort of patients suffering from autoimmune encephalitis (AE) and to search for correlations with the course of the disease.
We retrospectively collected clinical and paraclinical data of patients with AE, including brain F-FDG PET/CT. Whole-brain statistical analysis was performed using SPM8 software after activity parametrization to the striatum in comparison to healthy subjects. The discriminative performance of this metabolic ratio was evaluated in patients with AE using receiver operating characteristic curves against 44 healthy subjects and a control group of 688 patients with MCI. Relationship between cortex/striatum metabolic ratios and clinical/paraclinical data was assessed using univariate and multivariate analysis in patients with AE.
Fifty-six patients with AE were included. In comparison to healthy subjects, voxel-based statistical analysis identified one large cluster (p-cluster < 0.05, FWE corrected) of widespread decreased cortex/striatum ratio in patients with AE. The mean metabolic ratio was significantly lower for AE patients (1.16 ± 0.13) than that for healthy subjects (1.39 ± 0.08; p < 0.001) and than that for MCI patients (1.32 ± 0.11; p < 0.001). A ratio threshold of 1.23 allowed to detect AE patients with a sensitivity of 71% and a specificity of 82% against MCI patients, and 98% against healthy subjects. A lower cortex/striatum metabolic ratio had a trend towards shorter delay before F-FDG PET/CT (p = 0.07) in multivariate analysis.
The decrease in the cortex/striatal metabolic ratio has a good early diagnostic performance for the differentiation of AE patients from controls.
本 [F]-FDG PET 研究旨在确定在患有自身免疫性脑炎（AE）的大患者队列中皮质/纹状体代谢比的诊断价值，并寻找与疾病进程的相关性。
我们回顾性收集了 AE 患者的临床和辅助检查数据，包括脑 F-FDG PET/CT。使用 SPM8 软件进行全脑统计分析，在与健康受试者进行纹状体比较后，对活动进行参数化。使用接收者操作特征曲线在 AE 患者中评估该代谢比的判别性能，将其与 44 名健康受试者和 688 名 MCI 患者的对照组进行比较。在 AE 患者中，使用单变量和多变量分析评估皮质/纹状体代谢比与临床/辅助检查数据之间的关系。
共纳入 56 例 AE 患者。与健康受试者相比，基于体素的统计分析在 AE 患者中发现了一个广泛的皮质/纹状体比率降低的大集群（p-集群 < 0.05，FWE 校正）。AE 患者的平均代谢比明显低于健康受试者（1.16 ± 0.13）和 MCI 患者（1.32 ± 0.11；p < 0.001）。1.23 的比率阈值可用于检测 AE 患者，其对 MCI 患者的敏感性为 71%，特异性为 82%，对健康受试者的特异性为 98%。在多变量分析中，较低的皮质/纹状体代谢比与 F-FDG PET/CT 前的延迟时间较短呈趋势相关（p = 0.07）。
皮质/纹状体代谢比的降低对区分 AE 患者与对照组具有良好的早期诊断性能。
