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Dynamic 18 F-FDG PET to detect differences among patients with progressive and relapsing multiple sclerosis: a pilot
Carlos Quintanilla-Bordás1, Matías Fernández-Patón2, Amadeo Ten2
1Neuroimmunology Unit, La Fe University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, Valencia, 46026, Spain. carlosqb@gmail.com.
Background:
Patients with multiple sclerosis (MS) may remain in a relapsing-remitting (RRMS) course despite long-standing disease, while others will develop secondary progression (SPMS). Chronic inflammation and changes in the blood-brain barrier resulting in perturbed glucose metabolism may account for these differences. PET-MRI with kinetic analysis of 2-deoxy-2(18 F)fluoro-d-glucose (18 F-FDG) provides insight into glucose metabolism and has proven useful in several chronic inflammatory diseases. However, to our knowledge, it has never been studied in MS.
Objective:
To explore potential differences in glucose distribution kinetics among individuals with long-standing SPMS and RRMS using dynamic 18-F-FDG PET-MRI.
Methods:
Dynamic 18-F-FDG PET-MRI scans were obtained in 11 patients with long-standing MS: 4 with RRMS and 7 with SPMS. Kinetic analysis of PET data was performed using a three-compartment model equation that represents plasma, tissue and 18 F-FDG phosphorylation. Individual rate constants of 18-F-FDG across the compartments were calculated.
Results:
Patients with SPMS exhibited a trend towards an increased net influx rate of glucose (p = 0.059) and an increased rate constant representing glucose phosphorylation. Together, the data suggest increased uptake of glucose and glycolysis in these patients.
Conclusion:
Dynamic 18 F-FDG PET-MRI is a feasible technique that may show information in vivo of glucose metabolism in MS. Although preliminary data suggest a potential radiological marker of progression in MS, further studies are required to confirm this hypothesis.
Insights
Dynamic 18-F-FDG PET-MRI shows potential differences in glucose metabolism between relapsing-remitting and secondary progressive multiple sclerosis (MS). This technique may offer a new radiological marker for MS progression.
Area of Science:
- Neuroimaging
- Nuclear Medicine
- Biochemistry
Background:
- Multiple Sclerosis (MS) presents as relapsing-remitting (RRMS) or secondary progressive (SPMS) forms.
- Chronic inflammation and altered blood-brain barrier function in MS may impact glucose metabolism.
- Positron emission tomography-magnetic resonance imaging (PET-MRI) with 2-deoxy-2(18F)fluoro-d-glucose (18F-FDG) assesses glucose metabolism but hasn't been studied in MS.
Purpose of the Study:
- To investigate glucose distribution kinetics differences between long-standing SPMS and RRMS using dynamic 18F-FDG PET-MRI.
- To explore the potential of dynamic 18F-FDG PET-MRI as a tool for understanding MS pathophysiology.
Main Methods:
- Dynamic 18F-FDG PET-MRI scans were performed on 11 patients with long-standing MS (4 RRMS, 7 SPMS).
- Kinetic analysis utilized a three-compartment model to calculate individual rate constants for 18F-FDG.
- This method quantures glucose uptake and phosphorylation dynamics.
Main Results:
- Patients with SPMS showed a trend towards increased net glucose influx rate (p=0.059).
- SPMS patients also exhibited an increased rate constant for glucose phosphorylation.
- These findings suggest heightened glucose uptake and glycolysis in SPMS.
Conclusions:
- Dynamic 18F-FDG PET-MRI is a feasible method for in vivo glucose metabolism assessment in MS.
- Preliminary results indicate a potential radiological marker for MS progression.
- Further research is necessary to validate these findings and their clinical implications.
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