RESEARCH: [18 F] fluorodeoxyglucose (FDG) PET Scans

[Guest guest]

These would be some articles to share with your doctors if you want to ask

them about the FDG Pet Scan.

Regards,

Pam

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J Neurol Sci 2002 Aug 15;200(1-2):79-84

Cerebral metabolic changes in early multiple system atrophy: a PET study.

Taniwaki T, Nakagawa M, Yamada T, Yoshida T, Ohyagi Y, Sasaki M, Kuwabara Y,

Tobimatsu S, Kira J.

Department of Neurology, Graduate School of Medical Sciences, Kyushu

University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan

Previous positron emission tomography (PET) studies have shown widespread

hypometabolism in the brain of advanced MSA but the time course of these

metabolic abnormalities is largely unknown. In order to clarify the

principal disease processes in multiple system atrophy (MSA) in the early

stage, we investigated regional cerebral glucose metabolism (rCMGglc) and

nigral dopaminergic function in nine patients with early stage of MSA using

[18F]fluorodeoxyglucose (FDG) and 6-L-[18F]fluorodopa (18F-Dopa) positron

emission tomography (PET) (two men and seven women; age, 59.3+/-5.4 years;

disease duration, 29.7+/-14.6 months). The rCMRglc in the early MSA patients

significantly decreased in the cerebellum, brainstem, and striatum compared

with that in nine normal subjects. A significant correlation was found

between the severity of autonomic dysfunction and rCMRglc within the

brainstem. The severity of extrapyramidal signs also correlated with the

decline of F-Dopa uptake but not that of rCMRglc within the striatum. The

degree of atrophy on MRI has correlated with neither the clinical symptoms

nor rCMRglc at the cerebellum and the brainstem. Our PET studies

demonstrated widespread metabolic abnormalities except for the cerebral

cortex in the brain of MSA even in the early stage. The hypometabolism in

the brainstem was tightly linked to the autonomic dysfunction. Not the

striatal dysfunction but the nigral damage may be responsible for the

extrapyramidal symptoms in early MSA.

PMID: 12127681 [PubMed - in process]

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Mov Disord 1998 Mar;13(2):268-74

Differential diagnosis of parkinsonism with [18F]fluorodeoxyglucose and PET.

Antonini A, Kazumata K, Feigin A, Mandel F, Dhawan V, Margouleff C,

Eidelberg D.

Movement Disorders Center, Department of Neurology, North Shore University

Hospital, Manhasset, New York 11030, USA.

The clinical differentiation between typical idiopathic Parkinson's disease

(IPD) and atypical parkinsonian disorders (APD) is complicated by the

presence of signs and symptoms common to both forms of parkinsonism.

Metabolic brain imaging with [18F]fluorodeoxyglucose (FDG) and positron

emission tomography (PET) may be a useful adjunct in differentiating APD

from IPD. To explore this possibility, we studied 48 parkinsonian patients

suspected as having possible APD because of a deteriorating response to

dopaminergic treatment, the development of autonomic dysfunction, or both. A

group of 56 patients with likely IPD served as control subjects. We used

quantitative FDG/PET to measure regional rates of cerebral glucose use in

IPD and APD patients. We used discriminant analysis to categorize IPD and

APD patients based on their regional metabolic data. We found that a linear

combination of caudate, lentiform, and thalamic values accurately

discriminated APD from IPD patients (p < 0.0001). Significant metabolic

abnormalities were present in the striatum and the thalamus of 36 of 48

(75%) APD patients. Our findings show that measurements of regional glucose

metabolism can be used to discriminate patients with suspected APD from

their counterparts with classic IPD. FDG/PET may be a useful adjunct to the

clinical examination in the differential diagnosis of parkinsonism.

PMID: 9539340 [PubMed - indexed for MEDLINE]

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Brain 1997 Dec;120 ( Pt 12):2187-95

Complementary PET studies of striatal neuronal function in the differential

diagnosis between multiple system atrophy and Parkinson's disease.

Antonini A, Leenders KL, Vontobel P, Maguire RP, Missimer J, Psylla M,

Gunther I.

PET Department, Scherrer Institute, Villigen, Switzerland.

We used PET with the tracers [18F]fluorodeoxyglucose (FDG), [18F]fluorodopa

(FDOPA) and [11C]raclopride (RACLO) to study striatal glucose and dopa

metabolism, and dopamine D2 receptor binding, respectively, in nine patients

with multiple system atrophy. Ten patients with classical Parkinson's

disease were investigated with the same three PET tracers' and three

separate groups, each of 10 healthy subjects, served as control populations.

We found that striatal FDOPA values separated all healthy subjects from

patients with parkinsonism but they were not useful in distinguishing

multiple system atrophy from Parkinson's disease. Conversely, striatal RACLO

as well as FDG values discriminated all multiple system atrophy from

Parkinson's disease patients as well as from healthy control subjects.

Metabolic and receptor binding decrements in the putamen of multiple system

atrophy patients were significantly correlated. Stepwise regression analysis

revealed that a linear combination of putamen RACLO and FDOPA values

accurately predicted clinical measures of disease severity in the multiple

system atrophy group. Our findings suggest that striatal FDG and

particularly RACLO are sensitive and effective measures of striatal function

and may help characterizing patients with multiple system atrophy. In

contrast, FDOPA measurements are accurate in detecting abnormalities of the

nigrostriatal dopaminergic system but may not distinguish among different

forms of parkinsonism.

PMID: 9448574 [PubMed - indexed for MEDLINE]

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Ann Nucl Med 1997 Aug;11(3):251-7

Differentiating between multiple system atrophy and Parkinson's disease by

positron emission tomography with 18F-dopa and 18F-FDG.

Otsuka M, Kuwabara Y, Ichiya Y, Hosokawa S, Sasaki M, Yoshida T, Fukumura T,

Kato M, Masuda K.

Department of Radiology, Kyushu University, Beppu, Japan.

Both the striatal 18F-dopa uptake and brain glucose metabolism were studied

by PET with 6-L-[18F]fluorodopa (FD) and [18F]fluorodeoxyglucose (FDG) in 9

patients with multiple system atrophy (MSA) and 15 patients with idiopathic

Parkinson's disease (PD). Five of the 9 MSA patients were diagnosed as

having olivopontocerebellar atrophy, whereas 2 had striatonigral

degeneration and 2 demonstrated Shy-Drager syndrome. The FD uptake ratios to

the occipital cortex in the MSA patients at 120 min after the administration

of FD were 2.07 +/- 0.31 (mean +/- SD) and 1.96 +/- 0.29 in the caudate and

the putamen, respectively, and decreased compared to those in the controls

(2.72 +/- 0.11, 2.71 +/- 0.10). The same ratios in the PD patients were 2.07

+/- 0.36 and 1.74 +/- 0.24, respectively, which also decreased, but the

decreased uptake in the putamen was more prominent. The caudate-putamen

index (CPI)(%), which was calculated by a formula based on the difference in

the uptakes in the caudate and putamen divided by the caudate uptake,

indicated 5.6 +/- 4.6 in the MSA patients and 14.8 +/- 5.4 in the PD

patients. The CPI for all PD patients was more than 7.0, which was the mean

+ 2SD for the controls, but the CPI for 3 MSA patients was more than 7.0

(accuracy: 88%). The glucose metabolic rates for each region in the PD

patients showed no difference from the normal controls. The frontal and the

temporal cortical glucose metabolism and the caudate, the putaminal, the

cerebellar and the brainstem glucose metabolism in the MSA patients

decreased significantly in comparison to those in the controls. But, as the

glucose metabolic rates in such regions of each patient overlapped in the

two groups, the accuracy of the FDG study for differentiation was lower than

that of the FD study. The putaminal glucose metabolic rates, for example, in

3 PD patients were less than 6.8 (mg/min/100 ml), which was the mean-2SD for

the controls, while those in 3 MSA patients were more than 6.8 (accuracy:

75%). In addition, the combination of these two methods slightly improved

the accuracy. The glucose metabolism is useful for evaluating the regional

metabolic activity of the brain, and the FD study, which is specific to the

dopamine system, seems to be more useful for differentiating between MSA and

PD.

PMID: 9310175 [PubMed - indexed for MEDLINE]