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Wu GR, Baeken C. Brainstem glucose metabolism predicts reward dependence scores in treatment-resistant major depression. Psychol Med 2022; 52:3260-3266. [PMID: 33504370 PMCID: PMC9693681 DOI: 10.1017/s0033291720005425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/22/2020] [Accepted: 12/23/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND It has been suggested that individual differences in temperament could be involved in the (non-)response to antidepressant (AD) treatment. However, how neurobiological processes such as brain glucose metabolism may relate to personality features in the treatment-resistant depressed (TRD) state remains largely unclear. METHODS To examine how brainstem metabolism in the TRD state may predict Cloninger's temperament dimensions Harm Avoidance (HA), Novelty Seeking (NS), and Reward Dependence (RD), we collected 18fluorodeoxyglucose positron emission tomography (18FDG PET) scans in 40 AD-free TRD patients. All participants were assessed with the Temperament and Character Inventory (TCI). We applied a multiple kernel learning (MKL) regression to predict the HA, NS, and RD from brainstem metabolic activity, the origin of respectively serotonergic, dopaminergic, and noradrenergic neurotransmitter (NT) systems. RESULTS The MKL model was able to significantly predict RD but not HA and NS from the brainstem metabolic activity. The MKL pattern regression model identified increased metabolic activity in the pontine nuclei and locus coeruleus, the medial reticular formation, the dorsal/median raphe, and the ventral tegmental area that contributed to the predictions of RD. CONCLUSIONS The MKL algorithm identified a likely metabolic marker in the brainstem for RD in major depression. Although 18FDG PET does not investigate specific NT systems, the predictive value of brainstem glucose metabolism on RD scores however indicates that this temperament dimension in the TRD state could be mediated by different monoaminergic systems, all involved in higher order reward-related behavior.
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Affiliation(s)
- Guo-Rong Wu
- Faculty of Psychology, Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Chris Baeken
- Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
- Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Wu GR, Baeken C. Lateralized subgenual ACC metabolic connectivity patterns in refractory melancholic depression: does it matter? Cereb Cortex 2022; 33:3490-3497. [PMID: 35984291 DOI: 10.1093/cercor/bhac286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Although treatment resistance to antidepressant pharmacotherapy is quite common, the phenomenon of refractory major depressive disorder (rMDD) is not well understood. Nevertheless, the metabolic activity of the subgenual anterior cingulate cortex (sgACC) has been put forward as a possible metabolic biomarker of clinical prediction and response, albeit sgACC lateralization differences in functional connectivity have not yet been extensively examined. Also not in the refractory depressed state. To examine sgACC lateralization differences in metabolic connectivity, we recruited 43 right-handed antidepressant-free unipolar melancholic rMDD patients and 32 right-handed healthy controls to participate in this 18FDG PET study and developed a searchlight-based interregional covariance connectivity approach. Compared to non-depressed individuals, sgACC covariance analysis showed stronger metabolic connections with frontolimbic brain regions known to be affected in the depressed state. Furthermore, whereas the left sgACC showed stronger metabolic connections with ventromedial prefrontal cortical regions, implicated in anhedonia, suicidal ideation, and self-referential processes, the right sgACC showed significantly stronger metabolic connections with posterior hippocampal and cerebellar regions, respectively specialized in memory and social processing. Overall, our results substantiate earlier research that the sgACC is a metabolic key player when clinically depressed and that distinct lateralized sgACC metabolic connectivity patterns are present.
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Affiliation(s)
- Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing 400715, China.,School of Psychology, Jiangxi Normal University, Nanchang 330022, China.,Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent 9000, Belgium
| | - Chris Baeken
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent 9000, Belgium.,Department of Psychiatry, University Hospital (UZBrussel), Brussels 1090, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, 5600 MB, The Netherlands
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Laffon E, Marthan R. On Semi-quantitative Methods for Assessing Vascular 18FDG-PET Activity in Large-Vessels Vasculitis. J Nucl Med 2021; 63:325-326. [PMID: 34475239 DOI: 10.2967/jnumed.121.263060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 08/16/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022] Open
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Mahmoodi Z, Salarzaei M, Sheikh M. Prosthetic vascular graft infection: A systematic review and meta-analysis on diagnostic accuracy of 18FDG PET/CT. Gen Thorac Cardiovasc Surg 2021; 70:219-229. [PMID: 34309812 DOI: 10.1007/s11748-021-01682-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/10/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION There is a high risk of mortality and morbidity associated with Vascular Graft Infections (VGI) which requires early diagnosis. The aim of the present systematic review and meta-analysis was to evaluate the diagnostic accuracy, sensitivity and specificity of 18FDG PET/CT in diagnosing VGI. METHODS A systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. We evaluated five parameters including specificity, sensitivity, negative and positive predictive values (NPV and PPV), and accuracy. We used STATA/MP 15.0 (StataCorp, College Station, TX) for all of our analyses. RESULTS Overall 10 studies including 320 patients undergone 18FDG PET/CT were included. The sensitivity, specificity, positive and negative likelihood ratios along with their 95% CI were 0.92 (95% CI 0.88-0.95), 0.76 (95% CI 0.76-0.70), 3.49 (95% CI 3.49-2.32) and 0.14 (95% CI 0.09-0.23), respectively. The diagnostic odds ratio (DOR) for diagnosis of VGI was 37.12 (95% CI 14.84-92.82). The mean cut-off value of the maximum standardized uptake value (SUVmax) for diagnosis of VGI was 5.39 while the overall mean SUVmax among patients with VGI was 8.47. CONCLUSION According to our results, 18FDG PET/CT is a useful diagnostic method in detecting active VGI with high diagnostic accuracy. Because of its ability to evaluate morphology and main texture using SUVmax, the 18FDG PET/CT provides an objective assessment of aspects and extent of disease activity, which results in preventing unnecessary surgery, proper treatment planning, and evaluating the effectiveness of treatment.
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Affiliation(s)
- Zohre Mahmoodi
- Department of Cardiology, Zabol University of Medical Sciences, Zabol, Iran
| | - Morteza Salarzaei
- General Physician, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahboobeh Sheikh
- Department of Cardiology, Zabol University of Medical Sciences, Zabol, Iran.
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Hosp JA, Dressing A, Blazhenets G, Bormann T, Rau A, Schwabenland M, Thurow J, Wagner D, Waller C, Niesen WD, Frings L, Urbach H, Prinz M, Weiller C, Schroeter N, Meyer PT. Cognitive impairment and altered cerebral glucose metabolism in the subacute stage of COVID-19. Brain 2021; 144:1263-1276. [PMID: 33822001 PMCID: PMC8083602 DOI: 10.1093/brain/awab009] [Citation(s) in RCA: 203] [Impact Index Per Article: 67.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/25/2020] [Accepted: 10/29/2020] [Indexed: 12/11/2022] Open
Abstract
During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, neurological symptoms increasingly moved into the focus of interest. In this prospective cohort study, we assessed neurological and cognitive symptoms in hospitalized coronavirus disease-19 (COVID-19) patients and aimed to determine their neuronal correlates. Patients with reverse transcription-PCR-confirmed COVID-19 infection who required inpatient treatment primarily because of non-neurological complications were screened between 20 April 2020 and 12 May 2020. Patients (age > 18 years) were included in our cohort when presenting with at least one new neurological symptom (defined as impaired gustation and/or olfaction, performance < 26 points on a Montreal Cognitive Assessment and/or pathological findings on clinical neurological examination). Patients with ≥2 new symptoms were eligible for further diagnostics using comprehensive neuropsychological tests, cerebral MRI and 18fluorodeoxyglucose (FDG) PET as soon as infectivity was no longer present. Exclusion criteria were: premorbid diagnosis of cognitive impairment, neurodegenerative diseases or intensive care unit treatment. Of 41 COVID-19 inpatients screened, 29 patients (65.2 ± 14.4 years; 38% female) in the subacute stage of disease were included in the register. Most frequently, gustation and olfaction were disturbed in 29/29 and 25/29 patients, respectively. Montreal Cognitive Assessment performance was impaired in 18/26 patients (mean score 21.8/30) with emphasis on frontoparietal cognitive functions. This was confirmed by detailed neuropsychological testing in 15 patients. 18FDG PET revealed pathological results in 10/15 patients with predominant frontoparietal hypometabolism. This pattern was confirmed by comparison with a control sample using voxel-wise principal components analysis, which showed a high correlation (R2 = 0.62) with the Montreal Cognitive Assessment performance. Post-mortem examination of one patient revealed white matter microglia activation but no signs of neuroinflammation. Neocortical dysfunction accompanied by cognitive decline was detected in a relevant fraction of patients with subacute COVID-19 initially requiring inpatient treatment. This is of major rehabilitative and socioeconomic relevance.
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Affiliation(s)
- Jonas A Hosp
- Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andrea Dressing
- Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ganna Blazhenets
- Department of Nuclear Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Bormann
- Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexander Rau
- Department of Neuroradiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marius Schwabenland
- Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johannes Thurow
- Department of Nuclear Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Wagner
- Division of Infectious Diseases, Department of Internal Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Cornelius Waller
- Department of Internal Medicine I, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wolf D Niesen
- Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marco Prinz
- Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, Germany
| | - Cornelius Weiller
- Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nils Schroeter
- Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Verger A, Doyen M, Campion JY, Guedj E. The pons as reference region for intensity normalization in semi-quantitative analysis of brain 18FDG PET: application to metabolic changes related to ageing in conventional and digital control databases. EJNMMI Res 2021; 11:31. [PMID: 33761019 PMCID: PMC7990981 DOI: 10.1186/s13550-021-00771-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/03/2021] [Indexed: 02/06/2023] Open
Abstract
Background The objective of the study is to define the most appropriate region for intensity normalization in brain 18FDG PET semi-quantitative analysis. The best option could be based on previous absolute quantification studies, which showed that the metabolic changes related to ageing affect the quasi-totality of brain regions in healthy subjects. Consequently, brain metabolic changes related to ageing were evaluated in two populations of healthy controls who underwent conventional (n = 56) or digital (n = 78) 18FDG PET/CT. The median correlation coefficients between age and the metabolism of each 120 atlas brain region were reported for 120 distinct intensity normalizations (according to the 120 regions). SPM linear regression analyses with age were performed on most significant normalizations (FWE, p < 0.05). Results The cerebellum and pons were the two sole regions showing median coefficients of correlation with age less than − 0.5. With SPM, the intensity normalization by the pons provided at least 1.7- and 2.5-fold more significant cluster volumes than other normalizations for conventional and digital PET, respectively. Conclusions The pons is the most appropriate area for brain 18FDG PET intensity normalization for examining the metabolic changes through ageing.
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Affiliation(s)
- A Verger
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, 54000, Nancy, France.,IADI, INSERM U1254, Université de Lorraine, 54000, Nancy, France
| | - M Doyen
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, 54000, Nancy, France.,IADI, INSERM U1254, Université de Lorraine, 54000, Nancy, France
| | - J Y Campion
- CNRS, Ecole Centrale de Marseille, UMR 7249, Institut Fresnel, Aix-Marseille Université, Marseille, France.,CERIMED, Aix-Marseille University, Marseille, France
| | - Eric Guedj
- CNRS, Ecole Centrale de Marseille, UMR 7249, Institut Fresnel, Aix-Marseille Université, Marseille, France. .,CERIMED, Aix-Marseille University, Marseille, France. .,Department of Nuclear Medicine, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France.
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Yesil Cinkir H, Elboga U. The effect of systemic inflammation indexes and 18FDG PET metabolic parameters on survival in advanced lung adenocarcinoma. Tumori 2020; 106:312-318. [PMID: 32326835 DOI: 10.1177/0300891620915789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the effect of systemic inflammation indexes and fluorine-18 fluorodeoxyglucose (18FDG) positron emission tomography (PET) metabolic parameters on survival in advanced lung adenocarcinoma. METHODS A total of 133 patients who underwent 18FDG PET for initial staging were investigated retrospectively. Baseline patient characteristics, routine blood test results, 18FDG PET metabolic parameters, and treatment history were examined. Overall survival (OS) was demonstrated by Kaplan-Meier analysis, and the curves were compared by the log-rank test. Systemic inflammation response index (SIRI) was defined as neutrophil x monocyte/lymphocyte count. RESULTS Lymphocyte/monocyte ratio (LMR) and SIRI were found to be significant for OS. The cutoff point was 2.25 for LMR. Median OS was 8 months for ⩽2.25 and 14 months for >2.25 (p = 0.005). For SIRI, the cutoff point was 2. SIRI ⩽2 was associated with a median OS of 16 months compared to 10 months for patients with SIRI >2 (p = 0.043). Maximum of standardized uptake value, total lesion glycolysis, and metabolic tumor volume were not found to be significant for OS (p = 0.225, p = 0.061, p = 0.355, respectively). No correlation was found between inflammatory indexes and PET metabolic parameters. CONCLUSION Age and LMR parameters were prognostic for survival in Cox regression analysis. There was no correlation between 18FDG PET parameters and inflammatory indexes.
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Affiliation(s)
- Havva Yesil Cinkir
- Department of Medical Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Umut Elboga
- Department of Nuclear Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Żarnowska I, Chrapko B, Gwizda G, Nocuń A, Mitosek-Szewczyk K, Gasior M. Therapeutic use of carbohydrate-restricted diets in an autistic child; a case report of clinical and 18FDG PET findings. Metab Brain Dis 2018; 33:1187-1192. [PMID: 29644487 PMCID: PMC6060754 DOI: 10.1007/s11011-018-0219-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 03/15/2018] [Indexed: 12/27/2022]
Abstract
The ketogenic diet (KD) is a high-fat, adequate-protein, and low-carbohydrate diet that has been used successfully in the treatment of refractory epilepsies for almost 100 years. There has been accumulating evidence to show that the KD may provide a therapeutic benefit in autism spectrum disorders, albeit by a yet-unknown mechanism. We report a case of a 6-year-old patient with high-functioning autism and subclinical epileptic discharges who responded poorly to several behavioural and psychopharmacological treatments. The patient was subsequently placed on the KD due to significant glucose hypometabolism in the brain as revealed by an 18FDG PET. As soon as one month after starting the KD, the patient's behavior and intellect improved (in regard to hyperactivity, attention span, abnormal reactions to visual and auditory stimuli, usage of objects, adaptability to changes, communication skills, fear, anxiety, and emotional reactions); these improvements continued until the end of the observation period at 16 months on the KD. The 18FDG PET, measured at 12 months on the KD, revealed that 18F-FDG uptake decreased markedly and diffusely in the whole cerebral cortex with a relatively low reduction in basal ganglia in comparison to the pre-KD assessment. It warrants further investigation if the 18FDG PET imaging could serve as a biomarker in identifying individuals with autism who might benefit from the KD due to underlying abnormalities related to glucose hypometabolism.
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Affiliation(s)
- Iwona Żarnowska
- Department of Pediatric Neurology, Gębali 6, 20-093, Lublin, Poland
| | - Beata Chrapko
- Department of Nuclear Medicine, Jaczewskiego 8c, 20-090, Lublin, Poland
| | - Grażyna Gwizda
- Department of Pediatric Otolaryngology, Phoniatry and Audiology, Gębali 6, 20-093, Lublin, Poland
| | - Anna Nocuń
- Department of Nuclear Medicine, Jaczewskiego 8c, 20-090, Lublin, Poland
| | | | - Maciej Gasior
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA, USA.
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Wu GR, Baeken C. Longer depressive episode duration negatively influences HF-rTMS treatment response: a cerebellar metabolic deficiency? Brain Imaging Behav 2017; 11:8-16. [PMID: 26780241 DOI: 10.1007/s11682-016-9510-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is an evidence based neurostimulation modality used to treat patients with Major Depressive Disorder (MDD). In spite that the duration of current a depressive episode has been put forward as a negative predictor for clinical outcome, little is known about the underlying neurobiological mechanisms of this phenomenon. To address this important issue, in a sample of 43 melancholic stage III treatment resistant antidepressant-free refractory MDD patients, we reanalysed regional cerebral glucose metabolism (CMRglc) before high frequency (HF)-rTMS treatment, applied to the left dorsolateral prefrontal cortex (DLPFC). Besides that a lower baseline cerebellar metabolic activity indicated negative clinical response, a longer duration of the depressive episode was a negative indicator for recovery and negatively influenced cerebellar CMRglc. This exploratory 18FDG PET study is the first to demonstrate that the clinical response of HF-rTMS treatment in TRD patients may depend on the metabolic state of the cerebellum. Our observations could imply that for left DLPFC HF-rTMS non-responders other brain localisations for stimulation, more specifically the cerebellum, may be warranted.
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Laffon E, de Clermont H, Lamare F, Marthan R. Estimating the amount of FDG uptake in physiological tissues. Nucl Med Biol 2014; 41:717-20. [PMID: 25073424 DOI: 10.1016/j.nucmedbio.2014.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/22/2014] [Accepted: 06/05/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION It is known that for a fixed amount of injected tracer, the amount available for a tissue of interest will be less if other tissues show intense uptake. The aim of this study was to estimate the magnitude of 2-deoxy-2-[(18)F]fluoro-D-glucose (18FDG) uptake amount in physiological tissues that may show an intense uptake in current clinical practice. METHODS A formula was established providing an estimate of the percentage of injected 18FDG molecules (P; in %) that are irreversibly trapped in an 18FDG-positive tissue during a PET examination. RESULTS P ≅ 0.17*exp(-λt(acq))*TLG/W, where λ is the (18)F physical decay constant, t(acq) is the injection-acquisition time delay, TLG is total lesion glycolysis (g) and W is the patient weight (kg). The magnitude of P was calculated in two patients showing an intense uptake in brown fat, myocardium and bowels: 0.5, 3.5, and 4.2% respectively. CONCLUSIONS A formula is available to quickly estimate the amount of 18FDG uptake in tissues. We suggest that the accumulation of different physiological uptakes may actually affect SUV quantification in a tissue of interest.
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Affiliation(s)
- E Laffon
- CHU de Bordeaux, Service de Médecine Nucléaire, F-33604 Pessac, France; Université de Bordeaux 2, Centre de Recherche Cardio-Thoracique, F-33076 Bordeaux, France; INSERM U 1045, Centre de Recherche Cardio-Thoracique, F-33076 Bordeaux, France.
| | - H de Clermont
- CHU de Bordeaux, Service de Médecine Nucléaire, F-33604 Pessac, France
| | - F Lamare
- CHU de Bordeaux, Service de Médecine Nucléaire, F-33604 Pessac, France
| | - R Marthan
- Université de Bordeaux 2, Centre de Recherche Cardio-Thoracique, F-33076 Bordeaux, France; INSERM U 1045, Centre de Recherche Cardio-Thoracique, F-33076 Bordeaux, France
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Filippi L, Sardella B, Ciorra A, Scopinaro F, Bagni O. Tumor thrombus in the renal vein from an adrenal metastasis of lung cancer: 18FDG PET/CT findings. Cancer Biother Radiopharm 2014; 29:189-92. [PMID: 24852381 DOI: 10.1089/cbr.2014.1612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tumor thrombus is a rare complication of solid cancer. The authors report a case of a 76-year-old woman presenting a thick walled cystic mass in the lower lobe of the left lung. 18FDG positron emission tomography (PET)/computed tomography (CT) was performed, showing tracer accumulation in the wall of the pulmonary lesion and in the mediastinal and hilar lymph nodes. Moreover, PET/CT depicted a gross mass in the left adrenal gland and a hypermetabolic focus corresponding to the anatomic location of the left renal vein. Contrast-enhanced CT, subsequently performed, confirmed PET findings in the lung, lymph nodes, and adrenal glands, also demonstrating marginal enhancement and intraluminal filling defect in the left renal vein, which was interpreted as tumor thrombus due to the 18FDG uptake at PET scan. CT-guided biopsy of the mass was positive for poorly differentiated carcinoma. 18FDG PET can be useful to diagnose tumor thrombus in oncological patients.
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Affiliation(s)
- Luca Filippi
- 1 Section of Nuclear Medicine, Santa Maria Goretti Hospital , Latina, Italy
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