Amyloid PET in pseudotumoral multiple sclerosis

Area of Science:

• Neurology
• Neuroimaging
• Demyelinating Diseases

Background:

• Pseudotumoral multiple sclerosis is a rare demyelinating central nervous system disease.
• Amyloid tracers in positron emission tomography (PET) show nonspecific white matter uptake, suggesting potential as a marker for multiple sclerosis (MS) white matter damage.

Observation:

• A 59-year-old woman with pathologically confirmed pseudotumoral MS underwent 18F-florbetaben amyloid PET.
• The patient presented with word-finding difficulties and hemianopia, with MRI revealing an infiltrating lesion in the left frontotemporal lobe.

Findings:

• 18F-florbetaben PET demonstrated reduced uptake in the white matter lesion compared to normal-appearing white matter (-40.5%).
• Lower standardized uptake values were observed in the pseudotumoral lesion than in other white matter lesions.
• Decreased tracer uptake extended beyond MRI-visible lesions.

Implications:

• This case highlights the utility of amyloid PET in evaluating white matter damage in pseudotumoral multiple sclerosis.
• Amyloid PET may serve as a valuable tool for assessing demyelinating diseases and their extent.