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Related Experiment Video

Updated: Oct 22, 2025

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Decrease in the cortex/striatum metabolic ratio on [18F]-FDG PET: a biomarker of autoimmune encephalitis.

Nicolas De Leiris1,2, Berangère Ruel3, Jean Vervandier1

  • 1Nuclear Medicine Department, Grenoble Alpes University Hospital, Grenoble, France.

European Journal of Nuclear Medicine and Molecular Imaging
|August 31, 2021
PubMed
Summary
This summary is machine-generated.

This study shows that a decreased cortex/striatum metabolic ratio on [18F]-FDG PET scans is a valuable early diagnostic marker for autoimmune encephalitis (AE). The findings aid in differentiating AE patients from healthy individuals and those with mild cognitive impairment.

Keywords:
BiomarkerEncephalitisInflammationMCIStatistical parametric mapping[18F]-FDG PET/CT

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Area of Science:

  • Neuroimaging
  • Nuclear Medicine
  • Neurology

Background:

  • Autoimmune encephalitis (AE) is a group of neurological disorders characterized by inflammation of the brain.
  • Accurate and early diagnosis of AE is crucial for timely treatment and improved patient outcomes.
  • Positron Emission Tomography (PET) imaging, particularly with [18F]-FDG, can assess brain metabolic activity.

Purpose of the Study:

  • To evaluate the diagnostic utility of the cortex/striatum metabolic ratio using [18F]-FDG PET in a large cohort of AE patients.
  • To investigate potential correlations between this metabolic ratio and the clinical course of autoimmune encephalitis.
  • To assess the ratio's ability to differentiate AE patients from healthy controls and patients with mild cognitive impairment (MCI).

Main Methods:

  • Retrospective collection of clinical and [18F]-FDG PET/CT data from 56 AE patients.
  • Voxel-based statistical analysis using SPM8, comparing AE patients to 44 healthy subjects and 688 MCI patients.
  • Receiver operating characteristic (ROC) curve analysis to determine the discriminative performance of the cortex/striatum metabolic ratio.

Main Results:

  • AE patients exhibited a significantly lower mean cortex/striatum metabolic ratio (1.16 ± 0.13) compared to healthy subjects (1.39 ± 0.08) and MCI patients (1.32 ± 0.11).
  • A ratio threshold of 1.23 demonstrated high diagnostic accuracy, distinguishing AE patients with 71% sensitivity and 82% specificity against MCI, and 98% against healthy controls.
  • A trend suggested that a lower metabolic ratio might correlate with a shorter delay before PET/CT imaging.

Conclusions:

  • The reduced cortex/striatum metabolic ratio on [18F]-FDG PET is a sensitive and specific indicator for early diagnosis of autoimmune encephalitis.
  • This metabolic ratio effectively differentiates AE patients from both healthy individuals and those with mild cognitive impairment.
  • The findings support the use of [18F]-FDG PET and the cortex/striatum ratio as a valuable tool in the diagnostic workup of AE.