Value of glucose metabolism in subtype differentiation and prognosis assessment of autoimmune encephalitis
10.3760/cma.j.cn321828-20250108-00007
- VernacularTitle:自身免疫性脑炎葡萄糖代谢特征在其亚型鉴别及预后评估中的价值
- Author:
Tianbin SONG
1
;
Weizhao LU
;
Meixiang YU
;
Jing ZHANG
;
Jie MA
;
Yu YANG
;
Chun ZHANG
;
Jie LU
Author Information
1. 首都医科大学宣武医院放射与核医学科、磁共振成像脑信息学北京市重点实验室、神经变性病教育部重点实验室，北京 100053
- Publication Type:Journal Article
- Keywords:
Autoimmune diseases of the nervous system;
Encephalitis;
Positron-emission tomography;
Tomography, X-ray computed;
Fluorodeoxyglucose F18
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(4):200-205
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of 18F-FDG PET brain glucose metabolism imaging in the subtype differential diagnosis and prognosis evaluation of autoimmune encephalitis (AE). Methods:A retrospective analysis was conducted on PET/CT brain glucose metabolism imaging data from 58 patients with AE (from August 2020 to June 2023, Xuanwu Hospital, Capital Medical University; 31 males, 27 females; age (47.4±16.9) years). Patients were divided into 4 groups: anti-leucine-rich glioma-inactivated protein 1(LGI1) antibody-related encephalitis group, anti- N-methyl- D-aspartate receptor (NMDAR) encephalitis group, anti-γ-amino butyric acid type B receptor (GABA BR) antibody-related encephalitis group, and other types of AE group. In addition, 20 cases were included in control group (6 males and 14 females, age (58.8±7.5) years). Visual assessment was performed to evaluate changes in brain glucose metabolism among patients with different subtypes of AE, and abnormal glucose metabolism brain regions were compared by independent-sample t test between different groups. Spearman rank correlation analysis was conducted between SUV ratio (SUVR) of abnormal brain regions and modified Rankin Scale (mRS) scores at six months later. Results:Among 58 patients, 21 were diagnosed with anti-LGI1 antibody-related encephalitis, 18 were diagnosed with anti-NMDAR encephalitis, 7 were diagnosed with anti-GABA BR antibody-related encephalitis, and 12 were diagnosed with other subtypes of AE. Compared with anti-NMDAR encephalitis group: patients with anti-LGI1 antibody-related encephalitis showed increased glucose metabolism in the right occipital lobe and bilateral hippocampi, and decreased glucose metabolism in the right frontal lobe, right precentral gyrus, and bilateral superior marginal gyrus ( t values: from -5.13 to 4.89, all P<0.001); patients with anti-GABA BR antibody-related encephalitis exhibited increased glucose metabolism in the bilateral hippocampi and right fusiform gyrus, and decreased glucose metabolism in the left middle frontal gyrus ( t values: from -3.82 to 3.91, all P<0.001). Anti-NMDAR encephalitis was characterized by decreased metabolism in the bilateral parietal lobes, occipital lobes, local frontal-temporal lobes, and bilateral thalami, as well as increased metabolism in the limbic lobe and local frontal-temporal-parietal lobes ( t values: from -8.30 to 7.30, all P<0.001), and the SUVR of the right occipital lobe was negatively correlated with mRS score at six months later ( rs=-0.64, P=0.014). Other subtypes of AE showed decreased glucose metabolism in different cerebral lobes. Conclusion:18F-FDG PET/CT can evaluate brain glucose metabolism in different subtypes of AE diseases and prognosis.
