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Semi-quantitative analysis of cerebral FDG-PET reveals striatal hypermetabolism and normal cortical metabolism in a case of VGKCC limbic encephalitis.

Abstract In the context of delayed autoimmune encephalitis antibody results, functional imaging can support the diagnosis of limbic encephalitis associated with anti-voltage-gated potassium channel complex (VGKCC) antibodies. Here we present a typical case of VGKCC encephalitis in a 69-year-old woman whose symptoms responded to plasmapheresis. A cerebral 18F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) scan performed prior to commencing treatment revealed striatal hypermetabolism assessed qualitatively and semi-quantitatively, with normal uptake in the cortex and cerebellum when analysed semi-quantitatively. Repeat FDG-PET imaging performed three months later revealed normalisation of striatal hypermetabolism. Previous case reports have described striatal hypermetabolism and/or cortical hypometabolism in patients with VGKCC encephalitis. However, most of these descriptions were based on qualitative analyses only and may represent the relative change in cortical metabolism compared with striatal metabolism. We recommend semi-quantitative analysis of cerebral FDG-PET, in addition to reporting the qualitative FDG-PET images.
PMID
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Authors

Mayor MeshTerms

Fluorodeoxyglucose F18

Limbic Encephalitis

Positron-Emission Tomography

Keywords

Voltage-gated potassium channel complex antibody-associated limbic encephalitis

cerebral FDG-PET

semi-quantitative analysis

striatal hypermetabolism

Journal Title the neuroradiology journal
Publication Year Start




PMID- 28424014
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170501
LR  - 20170501
IS  - 2385-1996 (Electronic)
IS  - 1971-4009 (Linking)
VI  - 30
IP  - 2
DP  - 2017 Apr
TI  - Semi-quantitative analysis of cerebral FDG-PET reveals striatal hypermetabolism
      and normal cortical metabolism in a case of VGKCC limbic encephalitis.
PG  - 160-163
LID - 10.1177/1971400916689578 [doi]
AB  - In the context of delayed autoimmune encephalitis antibody results, functional
      imaging can support the diagnosis of limbic encephalitis associated with
      anti-voltage-gated potassium channel complex (VGKCC) antibodies. Here we present 
      a typical case of VGKCC encephalitis in a 69-year-old woman whose symptoms
      responded to plasmapheresis. A cerebral 18F-fluoro-2-deoxy-d-glucose positron
      emission tomography (FDG-PET) scan performed prior to commencing treatment
      revealed striatal hypermetabolism assessed qualitatively and semi-quantitatively,
      with normal uptake in the cortex and cerebellum when analysed
      semi-quantitatively. Repeat FDG-PET imaging performed three months later revealed
      normalisation of striatal hypermetabolism. Previous case reports have described
      striatal hypermetabolism and/or cortical hypometabolism in patients with VGKCC
      encephalitis. However, most of these descriptions were based on qualitative
      analyses only and may represent the relative change in cortical metabolism
      compared with striatal metabolism. We recommend semi-quantitative analysis of
      cerebral FDG-PET, in addition to reporting the qualitative FDG-PET images.
FAU - Moloney, Patrick
AU  - Moloney P
AD  - 1 Department of Neurology, St. Vincent's University Hospital, Ireland.
FAU - Boylan, Ruth
AU  - Boylan R
AD  - 1 Department of Neurology, St. Vincent's University Hospital, Ireland.
FAU - Elamin, Marwa
AU  - Elamin M
AD  - 1 Department of Neurology, St. Vincent's University Hospital, Ireland.
FAU - O'Riordan, Sean
AU  - O'Riordan S
AD  - 1 Department of Neurology, St. Vincent's University Hospital, Ireland.
FAU - Killeen, Ronan
AU  - Killeen R
AD  - 2 Department of Radiology, St. Vincent's University Hospital, Ireland.
FAU - McGuigan, Christopher
AU  - McGuigan C
AD  - 1 Department of Neurology, St. Vincent's University Hospital, Ireland.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170101
PL  - United States
TA  - Neuroradiol J
JT  - The neuroradiology journal
JID - 101295103
RN  - 0 (Antibodies)
RN  - 0 (Potassium Channels, Voltage-Gated)
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - Aged
MH  - Antibodies/blood
MH  - Cerebral Cortex/diagnostic imaging
MH  - Corpus Striatum/*diagnostic imaging
MH  - Female
MH  - *Fluorodeoxyglucose F18
MH  - Humans
MH  - *Limbic Encephalitis/diagnostic imaging/immunology/pathology
MH  - *Positron-Emission Tomography
MH  - Potassium Channels, Voltage-Gated/immunology
OTO - NOTNLM
OT  - *Voltage-gated potassium channel complex antibody-associated limbic encephalitis
OT  - *cerebral FDG-PET
OT  - *semi-quantitative analysis
OT  - *striatal hypermetabolism
EDAT- 2017/04/21 06:00
MHDA- 2017/05/02 06:00
CRDT- 2017/04/21 06:00
AID - 10.1177/1971400916689578 [doi]
PST - ppublish
SO  - Neuroradiol J. 2017 Apr;30(2):160-163. doi: 10.1177/1971400916689578. Epub 2017
      Jan 1.

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