Regional Metabolic Abnormalities in Autoimmune Encephalitis: A Meta-analysis of 498 Cases With Brain FDG PET.
| Title: | Regional Metabolic Abnormalities in Autoimmune Encephalitis: A Meta-analysis of 498 Cases With Brain FDG PET. |
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| Authors: | Kosek S; Kilsved E; Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden.; Danfors T; Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden.; Cunningham JL; Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden.; Pavel R; Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden.; Rostedt Punga A; From the Department of Medical Sciences, Clinical Neurophysiology, Uppsala University, Uppsala, Sweden.; Burman J; Department of Medical Sciences, Translational Neurology, Uppsala University, Uppsala, Sweden.; Fällmar D; Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden. |
| Source: | Clinical nuclear medicine [Clin Nucl Med] 2025 Mar 01; Vol. 50 (3), pp. 208-213. Date of Electronic Publication: 2024 Nov 27. |
| Publication Type: | Journal Article; Meta-Analysis; Systematic Review |
| Language: | English |
| Journal Info: | Publisher: Lippincott Country of Publication: United States NLM ID: 7611109 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-0229 (Electronic) Linking ISSN: 03639762 NLM ISO Abbreviation: Clin Nucl Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, Lippincott. |
| MeSH Terms: | Encephalitis*/diagnostic imaging ; Encephalitis*/metabolism ; Brain*/diagnostic imaging ; Brain*/metabolism ; Hashimoto Disease*/diagnostic imaging ; Hashimoto Disease*/metabolism ; Fluorodeoxyglucose F18* ; Positron-Emission Tomography*; Humans ; Magnetic Resonance Imaging |
| Abstract: | Purpose: Autoimmune encephalitis (AIE) is a group of conditions that are insufficiently understood and difficult to diagnose. Several publications indicate that FDG PET has superior sensitivity compared with MRI. This study aimed to perform a systematic review of publications to assess the characteristics and frequency of brain FDG PET compared with MRI findings at the individual level in AIE, including case reports and case series. The resulting meta-analysis is complementary to previous publications with large or medium-sized cohorts.; Patients and Methods: The review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and aimed to identify all studies with at least 1 case of AIE in which brain FDG PET was performed. Results from MRI and FDG PET were extracted on a patient-by-patient basis.; Results: The literature search yielded 1303 results, of which 234 studies were included, containing 498 cases. Abnormal FDG PET findings are reported in 93% compared with 55% with MRI. The affected brain regions, rates of unilateral versus bilateral findings, and hypermetabolism versus hypometabolism are descriptively presented in tables categorized according to the associated antibody.; Conclusions: FDG PET detected abnormalities more frequently than MRI, particularly in cases with anti-NMDAR and anti-GABA-B antibodies. Findings include a high prevalence of hypermetabolism in the medial temporal lobes, but also a high prevalence of parietal and occipital hypometabolism. Results differed depending on the associated antibody. Overall, the findings strengthen the importance of FDG PET in patients with suspected AIE, and the antibody-related patterns of regional metabolic abnormalities indicate a high potential for further development as a diagnostic and prognostic tool.; (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Competing Interests: | Conflicts of interest and sources of funding: S.K., E.K., R.P., A.R.P., J.B., and D.F. report no conflicts of interest. J.L.C. has received lecturing fees from Otsuka Pharma Scandinavia, Janssen-Cilag AB, and H. Lundbeck AB. D.F. is supported by the Swedish Society for Medical Research (PD21-0136) and by Hjärnfonden (PS2021-0026). S.K. is supported by grants from the Centre for Clinical Research Region Värmland. J.L.C., D.F., and J.B. are members of the Swedish Immunopsychiatry Alliance supported by the Swedish Research Council (grants no. 2019-06082, 2022-06091). A.R.P. is supported by grants from the Erling-Persson Foundation (grant no. #2022_0030). |
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| Substance Nomenclature: | 0Z5B2CJX4D (Fluorodeoxyglucose F18) |
| SCR Disease Name: | Hashimoto's encephalitis |
| Entry Date(s): | Date Created: 20241127 Date Completed: 20250203 Latest Revision: 20250609 |
| Update Code: | 20260130 |
| DOI: | 10.1097/RLU.0000000000005574 |
| PMID: | 39601059 |
| Database: | MEDLINE |
Journal Article; Meta-Analysis; Systematic Review