RETRACTED ARTICLE: Neuroradiological advances detect abnormal neuroanatomy underlying neuropsychological impairments: the power of PET imaging

PET imaging reveals brain functional changes in internet gaming disorder

BACKGROUND

Internet gaming disorder is an increasing problem worldwide, resulting in critical academic, social, and occupational impairment. However, the neurobiological mechanism of internet gaming disorder remains unknown. The aim of this study is to assess brain dopamine D2 (D2)/Serotonin 2A (5-HT2A) receptor function and glucose metabolism in the same subjects by positron emission tomography (PET) imaging approach, and investigate whether the correlation exists between D2 receptor and glucose metabolism.

METHODS

Twelve drug-naive adult males who met criteria for internet gaming disorder and 14 matched controls were studied with PET and (11)C-N-methylspiperone ((11)C-NMSP) to assess the availability of D2/5-HT2A receptors and with (18)F-fluoro-D-glucose ((18)F-FDG) to assess regional brain glucose metabolism, a marker of brain function. (11)C-NMSP and (18)F-FDG PET imaging data were acquired in the same individuals under both resting and internet gaming task states.

RESULTS

In internet gaming disorder subjects, a significant decrease in glucose metabolism was observed in the prefrontal, temporal, and limbic systems. Dysregulation of D2 receptors was observed in the striatum, and was correlated to years of overuse. A low level of D2 receptors in the striatum was significantly associated with decreased glucose metabolism in the orbitofrontal cortex.

CONCLUSIONS

For the first time, we report the evidence that D2 receptor level is significantly associated with glucose metabolism in the same individuals with internet gaming disorder, which indicates that D2/5-HT2A receptor-mediated dysregulation of the orbitofrontal cortex could underlie a mechanism for loss of control and compulsive behavior in internet gaming disorder subjects.

Clinical impact of 18F-FDG-PET/CT in the extra cardiac work-up of patients with infective endocarditis

OBJECTIVE

The purpose of this study was to assess the clinical importance of 18F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE).

BACKGROUND

IE is a serious condition with a significant mortality. Besides the degree of valvular involvement, the prognosis relies crucially on the presence of systemic infectious embolism.

METHODS

Seventy-two patients (71% males and mean age 63 ± 17 years) with IE were evaluated with 18F-FDG-PET/CT in addition to standard work-up including patient history, physical examination, conventional imaging modalities, and weekly interdisciplinary conferences. When previous unknown lesions detected by 18F-FDG-PET/CT were confirmed by succeeding examinations, they were considered true positive new findings and were further assessed for their clinical importance. Number needed to investigate was calculated as the number of patients who needed to undergo 18F-FDG-PET/CT to find at least one clinical important true positive new finding, not identified by standard work-up prior to 18F-FDG-PET/CT.

RESULTS

18F-FDG-PET/CT detected 114 lesions and 64 were true positive, of which 25 were new findings and detected in 17 patients. In 11 patients, the lesions were considered to have a clinical importance; osteomyelitis (n = 7), iliopsoas abscess (n = 1), gastrointestinal lesions (n = 2), and vascular prosthetic graft (n = 1). Number needed to investigate was 7 (11 of 72 patients).

CONCLUSIONS

18F-FDG-PET/CT detected lesions of clinical importance in one of seven IE patients and may be a substantial imaging technique for tracing peripheral infectious embolism due to IE. Thus, 18F-FDG-PET/CT may help to guide adequate therapy and thereby improve the prognosis of patients with IE.