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Imaging CD19+ B Cells in an Experimental Autoimmune Encephalomyelitis Mouse Model using Positron Emission Tomography
Published on: January 20, 2023
18F-DPA714 PET/MRI as a potential imaging tool for detecting possible antibody-negative autoimmune encephalitis: a
Huanyu Meng1,2, Lu He1, Hangxing Chunyu3
1Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
Background And Objectives:
Conventional magnetic resonance imaging (MRI) used for detecting possible antibody-negative autoimmune encephalitis (AIE) often fails to meet the diagnostic requirements of this disease. Positron emission tomography (PET) with a translocator protein radioligand can help visualize microglia distribution density in inflammation-related diseases, thereby offering potentially incremental value to conventional MRI for the in vivo assessment of possible antibody-negative AIE.
Methods:
In this prospective study, 15 participants diagnosed with possible antibody-negative AIE and 10 healthy controls were enrolled (ClinicalTrials.gov: NCT05293405, dated March 15, 2022). All participants underwent hybrid 18F-DPA714 PET/MRI and evaluation for modified Rankin scale (mRS) score, clinical assessment scale for AIE (CASE), and appropriate antibodies. A positive finding was defined as the intensity of 18F-DPA714 uptake that was above a threshold of mean standardized uptake value ratio (SUVR) + two standard deviations of SUVR within the corresponding brain regions of healthy controls.
Results:
The positive detection rate of 18F-DPA714 PET for possible antibody-negative AIE was significantly higher than that of brain MRI (10/15 [67%] vs. 3/15 [20%]; P = 0.039). In addition, both the intensity and extent of 18F-DPA714 uptake were significantly associated with the CASE score (P = 0.002 and 0.001). Meanwhile, SUVR levels in the cerebellar region were significantly higher in patients with ataxia than in those without ataxia (P = 0.006). Furthermore, 18F-DPA714 uptake decreased in 5/10 [50%] patients who underwent follow-up PET/MRI, which mirrored their symptom relief.
Conclusion:
18F-DPA714 PET demonstrated its potentially incremental value to conventional MRI for detecting possible antibody-negative AIE.
Insights
18F-DPA714 PET shows higher detection rates for antibody-negative autoimmune encephalitis (AIE) than MRI. This novel PET imaging offers improved diagnostic value for AIE, aiding in early detection and patient management.
Area of Science:
- Neuroimaging
- Radiochemistry
- Immunology
Background:
- Conventional MRI often fails to diagnose antibody-negative autoimmune encephalitis (AIE).
- Positron emission tomography (PET) with translocator protein radioligands visualizes microglia density in inflammatory conditions.
- 18F-DPA714 PET may enhance in vivo assessment of AIE.
Purpose of the Study:
- To evaluate the diagnostic performance of 18F-DPA714 PET/MRI in detecting possible antibody-negative AIE.
- To compare 18F-DPA714 PET with conventional MRI for AIE diagnosis.
Main Methods:
- Prospective study of 15 possible antibody-negative AIE patients and 10 healthy controls.
- Hybrid 18F-DPA714 PET/MRI scans were performed.
- Positive findings defined by 18F-DPA714 uptake exceeding healthy control SUVR + 2 SD.
Main Results:
- 18F-DPA714 PET had a significantly higher detection rate (67%) than MRI (20%) for AIE (P=0.039).
- 18F-DPA714 uptake intensity and extent correlated with AIE clinical severity scores (P=0.002, P=0.001).
- Cerebellar uptake was higher in patients with ataxia (P=0.006); uptake reduction correlated with symptom improvement.
Conclusions:
- 18F-DPA714 PET shows superior diagnostic capability for antibody-negative AIE compared to conventional MRI.
- 18F-DPA714 PET offers valuable incremental diagnostic information for AIE.
- This PET tracer aids in assessing disease activity and treatment response in AIE.
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