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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare


A Journal on Nuclear Medicine and Molecular Imaging
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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2017 December;61(4):386-404

DOI: 10.23736/S1824-4785.17.03024-2

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Emerging clinical issues and multivariate analyses in PET investigations

Javier ARBIZU 1 , Alessandro GIULIANI 2, Jaime GÁLLEGO PEREZ-LARRAYA 3, Mario RIVEROL 3, Cathrine JONSSON 4, Berta GARCÍA-GARCÍA 1, Maribel MORALES 1, Laura IMAZ 3, Marco PAGANI 5, 6

1 Department of Nuclear Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain; 2 Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy; 3 Department of Neurology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain; 4 Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden; 5 Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy; 6 Department of Nuclear Medicine, Karolinska Hospital Stockholm, Stockholm, Sweden


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PET using 18F-2-fluoro-2-deoxy-D-glucose (FDG-PET) has been gradually introduced in the diagnostic clinical criteria of the most prevalent neurodegenerative diseases. Moreover, an increasing amount of literature has shown that the information provided by FDG-PET enhances the sensitivity of standard imaging biomarkers in less frequent disorders in which an early differential diagnosis can be of paramount relevance for patient management and outcome. Therefore emerging uses of FDG-PET may be important in prion diseases, autoimmune encephalitis (AE) and amyotrophic lateral sclerosis. Interestingly, FDG-PET findings can also be observed in the early phases of these conditions, even in the presence of normal magnetic resonance imaging scans. Thalamic hypometabolism is a common finding in sporadic Creutzfeldt-Jacob disease and fatal familiar insomnia patients, with further cortical synaptic dysfunction in the former. Limbic and extra-limbic metabolic abnormalities (more often hypermetabolism) can be observed in AE, although specific patterns may be seen within different syndromes associated with antibodies that target neuronal surface or synaptic antigens. FDG-PET shows its usefulness by discriminating patients with amyotrophic lateral sclerosis associated to upper motor neuron onset that evolve to frontotemporal dementia. Besides visual and voxel based image analysis, multivariate analysis as interregional correlation analysis and independent/principal component analysis have been successfully implemented to PET images increasing the accuracy of the discrimination of neurodegenerative diseases. The clinical presentation and current diagnostic criteria of these neurologic disorders as well as the emerging usefulness of FDG-PET in the diagnostic workup are presented and discussed in this review.


KEY WORDS: Fluorodeoxyglucose F18 - Prion diseases - Amyotrophic lateral sclerosis

inizio pagina

Publication History

Issue published online: September 20, 2017
Article first published online: July 27, 2017
Manuscript accepted: July 27, 2017
Manuscript received: July 25, 2017

Per citare questo articolo

Arbizu J, Giuliani A, Gállego Perez-Larraya J, Riverol M, Jonsson C, García-García B, et al. Emerging clinical issues and multivariate analyses in PET investigations. Q J Nucl Med Mol Imaging 2017;61:386-404. DOI: 10.23736/S1824-4785.17.03024-2

Corresponding author e-mail

jarbizu@unav.es