Clinical, Imaging, and Pathologic Characteristics of Patients With Right Versus Left Hemisphere-Predominant Logopenic Progressive Aphasia

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012322
Author(s):  
Marina Buciuc ◽  
Joseph R. Duffy ◽  
Mary M. Machulda ◽  
Jonathan Graff-Radford ◽  
Nha Trang Thu Pham ◽  
...  
Keyword(s):  
Left Hemisphere ◽  
Temporal Lobe ◽  
Fdg Pet ◽  
Similar Distribution ◽  
Dominant Hemisphere ◽  
Clinical Imaging ◽  
Progressive Aphasia ◽  
Fdg Pet Scan ◽  
Control Study ◽  
Pet Amyloid

Objective:To assess and compare demographic, clinical, neuroimaging and pathologic characteristics of a cohort of patients with right versus left hemisphere-predominant logopenic progressive aphasia (LPA).Methods:This is a case-control study of patients with LPA who were prospectively followed at Mayo Clinic and underwent an [18F]-fluorodeoxyglucose (FDG)-PET scan. Patients were classified as rLPA if right temporal lobe metabolism was ≥1 standard deviation lower than left temporal lobe metabolism. Patients with rLPA were frequency-matched 3:1 to typical left-predominant LPA based on degree of asymmetry and severity of temporal lobe metabolism. Patients were compared on clinical, imaging (MRI, FDG-PET, amyloid-beta- and tau-PET) and pathologic characteristics.Results:Of 103 prospectively recruited LPA patients, 8 (4 females) were classified as rLPA (7.8%); all rLPA cases were right-handed. rLPA patients had milder aphasia based on the Western Aphasia Battery-Aphasia Quotient (p=0.04) and less frequent phonologic errors (p=0.015). rLPA had shorter survival compared to typical LPA: hazard ratio 4.0(1.2- 12.9), p=0.02. There were no other differences in demographics, handedness, genetics, neurological or neuropsychological tests. Compared to the 24 frequency-matched typical LPA patients, rLPA showed greater frontotemporal hypometabolism of the non-dominant hemisphere on FDG-PET and less atrophy in amygdala and hippocampus of the dominant hemisphere. Autopsy evaluation revealed a similar distribution of pathologic findings in both groups, with Alzheimer’s disease pathologic changes being the most frequent pathology.Conclusions:Right LPA is associated with less severe aphasia but has shorter survival from reported symptom onset than typical LPA, possibly related to greater involvement of the non-dominant hemisphere.

Hypermetabolism of the Medial Temporal Lobe in Limbic Encephalitis on 18FDG-PET Scan: A Case Report

2001 ◽  
Vol 45 (3) ◽  
pp. 187-189 ◽  
Author(s):  
Duk L. Na ◽  
Dong Seok Hahm ◽  
Jung Mi Park ◽  
Sang Eun Kim
Keyword(s):  
Case Report ◽  
Temporal Lobe ◽  
Fdg Pet ◽  
Medial Temporal Lobe ◽  
Limbic Encephalitis ◽  
Pet Scan ◽  
Fdg Pet Scan

scholarly journals An evidence-based algorithm for the utility of FDG-PET for diagnosing Alzheimer's disease according to presence of medial temporal lobe atrophy

2016 ◽  
Vol 208 (5) ◽  
pp. 491-496 ◽  
Author(s):  
Michael J. Firbank ◽  
Jim Lloyd ◽  
David Williams ◽  
Robert Barber ◽  
Sean J. Colloby ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Temporal Lobe ◽  
Fdg Pet ◽  
Medial Temporal Lobe ◽  
Diagnostic Information ◽  
Pet Scan ◽  
Medial Temporal Lobe Atrophy ◽  
Fdg Pet Scan ◽  
Lobe Atrophy

BackgroundImaging biomarkers for Alzheimer's disease include medial temporal lobe atrophy (MTLA) depicted on computed tomography (CT) or magnetic resonance imaging (MRI) and patterns of reduced metabolism on fluorodeoxyglucose positron emission tomography (FDG-PET).AimsTo investigate whether MTLA on head CT predicts the diagnostic usefulness of an additional FDG-PET scan.MethodParticipants had a clinical diagnosis of Alzheimer's disease (n = 37) or dementia with Lewy bodies (DLB; n = 30) or were similarly aged controls (n = 30). We visually rated MTLA on coronally reconstructed CT scans and, separately and blind to CT ratings, abnormal appearances on FDG-PET scans.ResultsUsing a pre-defined cut-off of MTLA ⩾5 on the Scheltens (0–8) scale, 0/30 controls, 6/30 DLB and 23/30 Alzheimer's disease had marked MTLA. FDG-PET performed well for diagnosing Alzheimer's disease v. DLB in the low-MTLA group (sensitivity/specificity of 71%/79%), but in the high-MTLA group diagnostic performance of FDG-PET was not better than chance.ConclusionsIn the presence of a high degree of MTLA, the most likely diagnosis is Alzheimer's disease, and an FDG-PET scan will probably not provide significant diagnostic information. However, in cases without MTLA, if the diagnosis is unclear, an FDG-PET scan may provide additional clinically useful diagnostic information.

Crossed Cerebellar Diaschisis in Alzheimer’s Disease

2018 ◽  
Vol 15 (13) ◽  
pp. 1267-1275 ◽  
Author(s):  
F.E. Reesink ◽  
D. Vállez García ◽  
C.A. Sánchez-Catasús ◽  
D.E. Peretti ◽  
A.T. Willemsen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Left Hemisphere ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Pathophysiological Mechanism ◽  
Crossed Cerebellar Diaschisis ◽  
Amyloid Accumulation ◽  
Cerebellar Diaschisis ◽  
18F Fdg

Background: We describe the phenomenon of crossed cerebellar diaschisis (CCD) in four subjects diagnosed with Alzheimer’s disease (AD) according to the National Institute on Aging - Alzheimer Association (NIA-AA) criteria, in combination with 18F-FDG PET and 11C-PiB PET imaging. Methods: 18F-FDG PET showed a pattern of cerebral metabolism with relative decrease most prominent in the frontal-parietal cortex of the left hemisphere and crossed hypometabolism of the right cerebellum. 11C-PiB PET showed symmetrical amyloid accumulation, but a lower relative tracer delivery (a surrogate of relative cerebral blood flow) in the left hemisphere. CCD is the phenomenon of unilateral cerebellar hypometabolism as a remote effect of supratentorial dysfunction of the brain in the contralateral hemisphere. The mechanism implies the involvement of the cortico-ponto-cerebellar fibers. The pathophysiology is thought to have a functional or reversible basis but can also reflect in secondary morphologic change. CCD is a well-recognized phenomenon, since the development of new imaging techniques, although scarcely described in neurodegenerative dementias. Results: To our knowledge this is the first report describing CCD in AD subjects with documentation of both 18F-FDG PET and 11C-PiB PET imaging. CCD in our subjects was explained on a functional basis due to neurodegenerative pathology in the left hemisphere. There was no structural lesion and the symmetric amyloid accumulation did not correspond with the unilateral metabolic impairment. Conclusion: This suggests that CCD might be caused by non-amyloid neurodegeneration. The pathophysiological mechanism, clinical relevance and therapeutic implications of CCD and the role of the cerebellum in AD need further investigation.

scholarly journals Eccrine Porocarcinoma: A Challenging Diagnostic and Therapeutic Tumoral Entity

2021 ◽  
pp. 700-705
Author(s):  
Ha Mo Linh Le ◽  
Laurence Faugeras ◽  
Véronique De Moor ◽  
Caroline Fervaille ◽  
Thierry Vander Borght ◽  
...  
Keyword(s):  
Skin Lesion ◽  
Fdg Pet ◽  
Wide Local Excision ◽  
Inguinal Node ◽  
Disease Remission ◽  
Cutaneous Tumor ◽  
Case Surgery ◽  
Fdg Pet Scan ◽  
Work Up ◽  
Eccrine Porocarcinoma

Eccrine porocarcinoma is a rare malignant cutaneous tumor with high rates of extracutaneous spread, and its diagnosis and management can be quite challenging. This is a case of an 82-year-old woman presenting with an asymptomatic and chronic pubic skin lesion for whom the work-up required many investigations and procedures to confirm the diagnosis of metastatic eccrine porocarcinoma. Indeed, the patient underwent a wide local excision of the skin lesion, imaging with an FDG-PET scan, a colonoscopy, and two inguinal node dissections. As illustrated in this case, surgery should always be considered to achieve disease remission. Other treatments such as chemotherapy and radiotherapy have also been reported in the literature without clear standard guidelines.

Clinical course of primary progressive aphasia: clinical and FDG-PET patterns

2014 ◽  
Vol 262 (3) ◽  
pp. 570-577 ◽  
Author(s):  
Jordi A. Matias-Guiu ◽  
María Nieves Cabrera-Martín ◽  
Teresa Moreno-Ramos ◽  
Rocío García-Ramos ◽  
Jesús Porta-Etessam ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Clinical Course ◽  
Primary Progressive Aphasia ◽  
Progressive Aphasia ◽  
Primary Progressive

Prognostic value of pretransplantation positron emission tomography using fluorine 18-fluorodeoxyglucose in patients with aggressive lymphoma treated with high-dose chemotherapy and stem cell transplantation

Blood ◽  
2003 ◽  
Vol 102 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Karoline Spaepen ◽  
Sigrid Stroobants ◽  
Patrick Dupont ◽  
Peter Vandenberghe ◽  
Johan Maertens ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Prognostic Value ◽  
High Dose Chemotherapy ◽  
Emission Tomography ◽  
High Dose ◽  
Conventional Imaging ◽  
Positron Emission ◽  
Fdg Pet Scan ◽  
18F Fdg ◽  
Fluorine 18 Fluorodeoxyglucose

Abstract The study assessed the prognostic value of fluorine 18-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) after salvage chemotherapy before high-dose chemotherapy with stem cell transplantation (HDT/SCT) in patients with induction failure or relapsing chemosensitive lymphoma. Retrospective analysis of the clinical and conventional imaging data of 60 patients scheduled for HDT/SCT was performed in parallel with the analysis of the [18F]FDG-PET results. To determine the ability of [18F]FDG-PET to predict clinical outcome, PET images were reread without knowledge of conventional imaging and clinical history. Presence or absence of abnormal [18F]FDG uptake was related to progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier survival analysis. Thirty patients showed a negative [18F]FDG-PET scan before HDT/SCT; 25 of those remained in complete remission, with a median follow-up of 1510 days. Two patients died due to a treatment-related mortality but without evidence of recurrent disease at that time (228-462 days). Only 3 patients had a relapse (median PFS, 1083 days) after a negative [18F]FDG-PET scan. Persistent abnormal [18F]FDG uptake was seen in 30 patients and 26 progressed (median PFS, 402 days); of these 26, 16 died from progressive disease (median OS, 408 days). Four patients are still in complete remission after a positive scan. Comparison between groups indicated a statistically significant association between [18F]FDG-PET findings and PFS (P < .000001) and OS (P < .00002). [18F]FDG-PET has an important prognostic role in the pretransplantation evaluation of patients with lymphoma and enlarges the concept of chemosensitivity used to select patients for HDT/SCT. (Blood. 2003;102:53-59)

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