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Purpose: The aim was to determine the diagnostic value of the cortex/striatum metabolic ratio in 18F-FDG PET in a large cohort of patients suffering from dysimmune encephalitis (DE) and to search for clinical correlations with the course of the disease.
Methods: We retrospectively collected complete clinical and paraclinical data of DE patients, including brain 18F-FDG PET/CT. Whole-brain statistical analysis was performed using SPM8 software after activity parametrization to the striatum and in comparison to healthy subjects. Conventional discriminant analysis between the DE group and controls was performed using cluster metabolic ratios. A correlation analysis between cluster metabolic ratios and clinical/paraclinical data was assessed.
Results: Seventy-three patients with DE were included. In comparison to 44 controls, voxel-based statistical analysis identified one large cluster (p-voxel < 0.001 uncorrected; p-cluster<0.05, FWE corrected) of widespread decreased cortical metabolism relative to the striatum in DE patients. The mean parametrized cluster metabolic value was significantly lower for DE patients (1.06 ± 0.13) than for the control group (1.46 ± 0.08; p < 0.001). This cluster metabolic ratio correctly classified 97.4% of the individuals between patients with DE and healthy controls. Correlation analyses showed that a low cluster metabolic ratio was associated with higher risk of death (p = 0.04), the absence of autoantibodies (p = 0.05), and an increased delay between onset of symptoms and diagnostic (p = 0.01).
Conclusion: The decrease in the cortex/striatal metabolic ratio has a good diagnostic performance for the differentiation of DE patients from controls and seems to provide prognostic information on the clinical course.
Keywords
Encephalitis, 18F-FDG PET/CT, statistical parametric mapping, biomarker, inflammation
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CURRENT STATUS: Under Review
Version 1
Posted 22 Mar, 2021
No community comments so far
Reviews received
Received 18 Mar, 2021
Reviewers invited
Invitations sent on 18 Mar, 2021
First submitted
On 15 Mar, 2021
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On 14 Mar, 2021
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Subject Areas
Nuclear Medicine & Medical Imaging
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A new preprint design is coming!
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This preprint is under consideration at European Journal of Nuclear Medicine and Molecular Imaging. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 22 Mar, 2021
No community comments so far
Reviews received
Received 18 Mar, 2021
Reviewers invited
Invitations sent on 18 Mar, 2021
First submitted
On 15 Mar, 2021
Editor assigned
On 14 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nuclear Medicine & Medical Imaging
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: The aim was to determine the diagnostic value of the cortex/striatum metabolic ratio in 18F-FDG PET in a large cohort of patients suffering from dysimmune encephalitis (DE) and to search for clinical correlations with the course of the disease.
Methods: We retrospectively collected complete clinical and paraclinical data of DE patients, including brain 18F-FDG PET/CT. Whole-brain statistical analysis was performed using SPM8 software after activity parametrization to the striatum and in comparison to healthy subjects. Conventional discriminant analysis between the DE group and controls was performed using cluster metabolic ratios. A correlation analysis between cluster metabolic ratios and clinical/paraclinical data was assessed.
Results: Seventy-three patients with DE were included. In comparison to 44 controls, voxel-based statistical analysis identified one large cluster (p-voxel < 0.001 uncorrected; p-cluster<0.05, FWE corrected) of widespread decreased cortical metabolism relative to the striatum in DE patients. The mean parametrized cluster metabolic value was significantly lower for DE patients (1.06 ± 0.13) than for the control group (1.46 ± 0.08; p < 0.001). This cluster metabolic ratio correctly classified 97.4% of the individuals between patients with DE and healthy controls. Correlation analyses showed that a low cluster metabolic ratio was associated with higher risk of death (p = 0.04), the absence of autoantibodies (p = 0.05), and an increased delay between onset of symptoms and diagnostic (p = 0.01).
Conclusion: The decrease in the cortex/striatal metabolic ratio has a good diagnostic performance for the differentiation of DE patients from controls and seems to provide prognostic information on the clinical course.
Figure 1
Figure 2
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