Emerging clinical issues and multivariate analyses in PET investigations

Javier Arbizu, Alessandro Giuliani, Jaime Gállego Perez-Larraya, Mario Riverol, Cathrine Jonsson, Berta García-García, Maribel Morales, Laura Imaz, Marco Pagani

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish
Pages (from-to)386-404
Number of pages19
JournalQuarterly Journal of Nuclear Medicine and Molecular Imaging
Volume61
Issue number4
DOIs
Publication statusPublished - Dec 1 2017

Keywords

  • Amyotrophic lateral sclerosis
  • Fluorodeoxyglucose F18
  • Prion diseases

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Emerging clinical issues and multivariate analyses in PET investigations'. Together they form a unique fingerprint.

  • Cite this

    Arbizu, J., Giuliani, A., Gállego Perez-Larraya, J., Riverol, M., Jonsson, C., García-García, B., Morales, M., Imaz, L., & Pagani, M. (2017). Emerging clinical issues and multivariate analyses in PET investigations. Quarterly Journal of Nuclear Medicine and Molecular Imaging, 61(4), 386-404. https://doi.org/10.23736/S1824-4785.17.03024-2