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PET Imaging of Neuroinflammation Using [11C]DPA-713 in a Mouse Model of Ischemic Stroke
Published on: June 14, 2018
18F-DPA714 PET in MRI-negative autoimmune encephalitis: a supportive approach to aiding neuroinflammation
Huanyu Meng1,2, Yuanqi Qi1, Mengmeng Zhang3
1Department and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, China.
Purpose Of The Report:
Conventional magnetic resonance imaging (MRI) has limitations in detecting abnormalities in autoimmune encephalitis (AIE). This retrospective study evaluated the utility of 18F-DPA714 PET, a potential neuroinflammation biomarker, in MRI-negative AIE patients.
Materials And Methods:
60 MRI-negative possible AIE patients (mean age 31.68 ± 11.05 years; 60% male) and ten age-matched healthy controls underwent 18F-DPA714 PET. Only high-affinity translocator protein (TSPO) binders were included. Clinical severity scores (mRS, CASE) were collected. Abnormal PET uptake was defined voxel-wise, using a threshold of the mean SUVR + 2SDs derived from the HCs. 34 patients had follow-up PET/MRI post-immunotherapy.
Results:
Among the 60 MRI-negative AIE patients, 39 (65%) exhibited abnormally elevated 1⁸F-DPA714 uptake, with the highest positivity rate in the occipital lobes. Uptake patterns corresponded to specific symptoms, such as mesial temporal involvement in cognitive impairment. Quantitatively, baseline PET activity (SUVRmax, SUVRmean) was significantly correlated with baseline clinical severity (mRS, CASE). At follow-up, PET activity remained significantly correlated with mRS and CASE scores, and reductions in PET activity paralleled clinical improvement. Additionally, higher baseline PET activity was associated with greater subsequent brain volume loss.
Conclusion:
18F-DPA714 PET detected neuroinflammation in a substantial proportion of MRI-negative AIE patients, with quantitative uptake correlating with disease severity. Longitudinal findings suggest that post-treatment decreases in 18F-DPA714 uptake may be associated with reduced subsequent brain volume loss. These results support the potential role of 18F-DPA714 PET/MR as an adjunctive imaging method for disease assessment in MRI-negative AIE.
Insights
18F-DPA714 PET imaging detected neuroinflammation in most autoimmune encephalitis (AIE) patients with negative MRI scans. This neuroinflammation biomarker correlated with disease severity and predicted brain volume loss, supporting its use in AIE assessment.
Area of Science:
- Neuroimaging
- Nuclear Medicine
- Neurology
Background:
- Conventional magnetic resonance imaging (MRI) has limitations in detecting abnormalities in autoimmune encephalitis (AIE).
- 18F-DPA714 is a potential PET tracer for neuroinflammation, targeting the translocator protein (TSPO).
Purpose of the Study:
- To evaluate the utility of 18F-DPA714 PET in identifying neuroinflammation in patients with MRI-negative autoimmune encephalitis (AIE).
- To assess the correlation between 18F-DPA714 uptake, clinical severity, and treatment response in AIE.
Main Methods:
- Retrospective analysis of 60 MRI-negative possible AIE patients and 10 healthy controls who underwent 18F-DPA714 PET.
- Abnormal PET uptake was defined using a standardized uptake value ratio (SUVR) threshold derived from controls.
- Clinical severity was assessed using modified Rankin Scale (mRS) and Clinical Assessment Scale for Autoimmune Encephalitis (CASE); 34 patients had follow-up imaging.
Main Results:
- 18F-DPA714 PET showed abnormal uptake in 65% of MRI-negative AIE patients, particularly in the occipital lobes.
- Uptake patterns correlated with specific symptoms, and baseline PET activity (SUVRmax, SUVRmean) significantly correlated with baseline mRS and CASE scores.
- Follow-up PET activity correlated with mRS and CASE, with decreased uptake paralleling clinical improvement and higher baseline activity predicting greater brain volume loss.
Conclusions:
- 18F-DPA714 PET is effective in detecting neuroinflammation in a significant proportion of MRI-negative AIE patients.
- Quantitative 18F-DPA714 uptake correlates with AIE disease severity and may predict treatment response and subsequent brain volume loss.
- 18F-DPA714 PET/MR shows promise as an adjunctive tool for assessing disease activity and outcomes in MRI-negative AIE.
