The Role of Fdg-Pet, Hmpao-Spet and Mri in the Detection of Brain Involvement in Patients with Systemic Lupus Erythematosus
Resource
EUROPEAN JOURNAL OF NUCLEAR MEDICINE v.26 n.2 pp.129-134
Journal
EUROPEAN JOURNAL OF NUCLEAR MEDICINE
Journal Volume
v.26
Journal Issue
n.2
Pages
129-134
Date Issued
1999
Date
1999
Author(s)
KAO, CHIA-HUNG
LAN, JONNG-LIANG
CHANG, LAI SHENG-PING
LIAO, KO-KAUNG
YEN, RUOH- FANG
CHIENG, POON-UNG
Abstract
Involvement of the brain is one of the most important complications of systemic lupus erythematosus (SLE); however , its diagnosis is difficult due to the lack of effective imaging methods. We combined three brain imaging modalities- - positron emission tomography with fluorine-18 2- fluoro-2- deoxy-d-glucose (FDG-PET), single-photon emission computed tomography with technetium-99m hexamethylpropylene amine oxime(HMPAO-SPET) and magnetic resonance imaging (MRI) – in order to detect brain involvement in SLE. Thirty-seven SLE patients, aged 22-45 years, were divided into three groups. Group 1 (G1) consisted of ten patients with major neuropsychiatric manifestations; group 2 (G2) consisted of 15 patients with minor manifestations; and group 3 (G3) consisted of 12 patients without manifestations. FDG-PET findings were abnormal in 51% of patients: 90% of G1, 67% of G2 and 0% of G3 patients respectively. HMPAO- SPET findings were abnormal in 62% of patients: 100% of G1, 73% of G2 and 17% of G3 patients respectively. MRI findings were abnormal in 35% of patients: 70% of G1, 40% of G2 and 0% of G3 patients respectively. Grey matter was more commonly involved than white matter; 62% of patients presented with lesions in the cerebral cortex, 27% with lesions in the basal ganglion, 5% with lesions in the cerebellum, and 19% with lesions in white matter. No white matter lesions were found on FDG-PET or HMPAO-SPET . However, in 19% of patients, MRI demonstrated abnormally high signal lesions in white matter. Forty-three percent of cases had positive serum anticardiolipin antibodies (ACA). However, ACA was not related to FDG-PET, HMPAO-SPET or MRI findings. It may be concluding that HMPAO-SPET is a more sensitive tool for detecting brain involvement in SLE patients when compared with FDG-PET or MRI. However, MRI is necessary for detecting lesions in white matter.
Subjects
Fluorine-18 2-fluoro-2-deoxy-D-glucose
Positronemission tomography
Technetium-99m hexamethylpropylene amine oxime
Single-photon emission tomography
Magnetic resonance imaging
Systemic lupus erythematosus