PET is only moderately informative regarding theranostic Ttarget HIF-1α expression in solid tumors: A meta-analysis

2019 ◽  
Author(s):  
Alexey Surov ◽  
Stefan A. Schmidt ◽  
Vikas Prasad ◽  
Ambros J. Beer ◽  
Andreas Wienke
Keyword(s):  
Solid Tumors ◽  
Tumor Cells ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Correlation Coefficients ◽  
Hexokinase 2 ◽  
Primary Tumors ◽  
Glut 1 ◽  
Fdg Uptake ◽  
Specific Tumor

Abstract BACKGROUND: Hypoxia-inducible factor (HIF)-1α plays a key role in hypoxic adaptation of tumor cells. HIF-1α is overexpressed in solid tumor, directs the glucose metabolism pathway from oxidative to anaerobic pathway thereby reducing the oxygen consumption, decreases free radical level and thence prevents cancer cell death. 2-deoxy-2 [18F] fluoro-D-glucose (FDG) is taken up in solid tumors primarily regulated through glucose transporter 1 (GLUT-1) and hexokinase 2 which in turn are regulated by HIF-1α. Positron Emission Tomography (PET) with FDG allows semiquantitative delineation of GLUT-1 and Hexokinase 2 activity in tumor cells by standardized uptake value (SUV). There are inconsistent data about relationships between FDG-PET and HIF-1a. The purpose of the present analysis was to provide evidence regarding associations between FDG uptake measured as standardized uptake value (SUV) and HIF-1α expression in solid tumors. METHODS: MEDLINE library, SCOPUS and EMBASE data bases were screened for relationships between SUVmax and HIF-1a up to August 2019. Overall, 21 studies with 1154 patients were identified. The following data were extracted from the literature: authors, year of publication, number of patients, and correlation coefficients. RESULTS: Correlation coefficients between SUV and HIF-1α ranged from -0.51 to 0.71. The pooled correlation coefficient was 0.27, (95% CI = [0.14; 0.41]). Furthermore, correlation coefficients for specific tumor entities were calculated. For this sub-analysis, data for primary tumors with more than two reports were included. The calculated correlation coefficients in the analyzed subgroups were as follows: head and neck squamous cell carcinoma: ρ = 0.25 (95% CI = [0.07; 0.42]); non-small lung cell cancer: ρ = 0.27 (95% CI = [-0.14; 0.67]); uterine cervical cancer: ρ = -0.09 (95% CI = [- 0.89; 0.71]); thymic tumors: ρ = 0.39 (95% CI = [0.04; 0.58]) CONCLUSION: Published literature suggests wide heterogeneity and weak correlation between intensity of FDG uptake measured as SUVmax and expression of HIF-1a both in solid tumors in general and also in specific tumor subgroups. Because HIF-1α is a very important theranostic target, prospective state of the art studies are needed to elucidate the true potential of FDG PET in assessment of HIF-1α activity in solid tumors

FDG PET correlates weakly with HIF-1α expression in solid tumors: a meta-analysis

2020 ◽  
pp. 028418512093237
Author(s):  
Alexey Surov ◽  
Stefan A Schmidt ◽  
Vikas Prasad ◽  
Ambros J Beer ◽  
Andreas Wienke
Keyword(s):  
Solid Tumors ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Cell Cancer ◽  
Standardized Uptake Value ◽  
Correlation Coefficients ◽  
Analysis Data ◽  
Primary Tumors ◽  
Publication Number ◽  
Number Of Patients

Background Hypoxia-inducible factor (HIF)-1α plays a key role in hypoxic adaptation of tumor cells. Overexpression of HIF-1α is associated with tumor aggressiveness and worse prognosis in several malignancies. Presumably, expression of HIF-1a may be reflected by positron emission tomography with 2-deoxy-2 [fluorine-18] fluoro-D-glucose (18F-FDG PET). There are inconsistent data about relationships between FDG PET and HIF-1α. Purpose To provide evident data about associations between maximum standardized uptake value (SUVmax) and HIF-1α expression in solid tumors. Material and Methods MEDLINE, SCOPUS, and EMBASE databases were screened for relationships between SUV and HIF-1α up to August 2019. Overall, 21 studies with 1154 patients were identified. The following data were extracted from the literature: authors; year of publication; number of patients; and correlation coefficients. Results Correlation coefficients between SUVmax and HIF-1α were in the range of −0.51–0.71. The pooled correlation coefficient was 0.27 (95% confidence interval [CI] = 0.14–0.41). Furthermore, correlation coefficients for some tumor entities were calculated. For this sub-analysis, data for primary tumors with >2 reports were included. The calculated correlation coefficients in the analyzed subgroups were as follows: head and neck squamous cell carcinoma: ρ = 0.25 (95% CI = 0.07–0.42); non-small lung cell cancer: ρ = 0.27 (95% CI = −0.14–0.67); uterine cervical cancer: ρ = −0.09 (95% CI = −0.89–0.71); thymic tumors: ρ = 0.39 (95% CI = 0.04–0.58). Conclusion SUVmax of FDG PET correlated weakly with expression of HIF-1α both in overall sample and tumor subgroups. Therefore, FDG PET cannot be used for prediction of hypoxia in clinical practice.

scholarly journals The clinical impact of incidental sellar uptake on F-18 FDG PET/CT

2019 ◽  
Vol 6 (2) ◽  
pp. IJE15
Author(s):  
Zehra Pınar Koç ◽  
Pelin Özcan Kara ◽  
Emel Sezer ◽  
Kadir Eser ◽  
Anıl Özgür
Keyword(s):  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Sellar Region ◽  
Primary Tumors ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Frequent Finding ◽  
Metastatic Involvement ◽  
Fdg Pet Ct

Aim: The most frequent finding associated with incidental fluorodeoxyglucose (FDG) uptake in sellar region in oncologic F-18 FDG PET/CT is adenoma. However, reports of metastatic involvement exist. We investigated the clinical significance of incidental FDG uptake in this region. Materials & method: 34 patients with several primary tumors who were referred for staging, restaging or treatment response via F-18 FDG PET/CT were included. Images were reviewed and patients with significant FDG uptake in the sellar region were referred. Results: Mean lesion diameter was 11.9 ± 4.9 mm and mean standardized uptake value was 8.2 ± 6.1. Thirteen patients underwent MRI, and the others underwent follow-up F-18 FDG PET/CT. MRI revealed metastatic involvement in nine patients and macro- or micro-adenoma in four. Metastatic patients also had other lesions, yet management did not change. Conclusion: FDG accumulation in the sellar region might be associated with metastasis or adenoma. However, it did not change management. Future studies are warranted.

scholarly journals Pulmonary Findings of [18F]FDG PET/CT Images on Asymptomatic COVID-19 Patients

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 839
Author(s):  
Tzu-Chuan Ho ◽  
Chin-Chuan Chang ◽  
Hung-Pin Chan ◽  
Ying-Fong Huang ◽  
Yi-Ming Arthur Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Fdg Uptake ◽  
Asymptomatic Patients ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Maximal Standardized Uptake Value ◽  
Fdg Pet Ct

During the coronavirus disease 2019 (COVID-19) pandemic, several case studies demonstrated that many asymptomatic patients with COVID-19 underwent fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) examination for various indications. However, there is a lack of literature to characterize the pattern of [18F]FDG PET/CT imaging on asymptomatic COVID-19 patients. Therefore, a systematic review to analyze the pulmonary findings of [18F]FDG PET/CT on asymptomatic COVID-19 patients was conducted. This systematic review was performed under the guidelines of PRISMA. PubMed, Medline, and Web of Science were used to search for articles for this review. Articles with the key words: “asymptomatic”, “COVID-19”, “[18F]FDG PET/CT”, and “nuclear medicine” were searched for from 1 January 2020 to 20 May 2021. Thirty asymptomatic patients with COVID-19 were included in the eighteen articles. These patients had a mean age of 62.25 ± 14.85 years (male: 67.71 ± 12.00; female: 56.79 ± 15.81). [18F]FDG-avid lung lesions were found in 93.33% (28/30) of total patients. The major lesion was [18F]FDG-avid multiple ground-glass opacities (GGOs) in the peripheral or subpleural region in bilateral lungs, followed by the consolidation. The intensity of [18F]FDG uptake in multiple GGOs was 5.605 ± 2.914 (range from 2 to 12) for maximal standardized uptake value (SUVmax). [18F]FDG-avid thoracic lymph nodes (LN) were observed in 40% (12/40) of the patients. They mostly appeared in both mediastinal and hilar regions with an SUVmax of 5.8 ± 2.93 (range from 2.5 to 9.6). The [18F]FDG uptake was observed in multiple GGOs, as well as in the mediastinal and hilar LNs. These are common patterns in PET/CT of asymptomatic patients with COVID-19.

scholarly journals Coronary, aortic and carotid artery inflammation by 18F-fluorodeoxyglucose positron emission tomography in acute and chronic coronary artery disease

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
W Nammas ◽  
S Uotila ◽  
J Teuho ◽  
M Pietila ◽  
J Airaksinen ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Fdg Pet ◽  
Carotid Arteries ◽  
Standardized Uptake Value ◽  
Chronic Coronary Artery Disease ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Arterial Inflammation ◽  
18F Fdg ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Background 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) can detect arterial inflammation in individuals with atherosclerosis, but the associations among different vascular territories for 18F-FDG uptake are not known. Purpose We explored any possible correlation between arterial inflammation quantified by 18F-FDG PET in the aorta, carotid arteries, and coronary arteries in patients presenting with acute coronary syndrome (ACS), or chronic coronary artery disease (CAD). Methods Prospectively, we performed hybrid computed tomography angiography and 18F-FDG PET in 43 patients (26 ACS and 17 chronic CAD) at 6.6 ± 5.7 days following invasive coronary angiography. 18F-FDG PET was performed 90 minutes after injection of 302.2 ± 28.4 MBq 18F-FDG. Arterial 18F-FDG uptake was measured in the thoracic aorta, carotid arteries, and coronary arteries, and expressed as the target-to-background ratio (TBR; the ratio between arterial maximal standardized uptake value normalized to blood pool mean standardized uptake value) in the whole artery, and in the most diseased segment (MDS). Results Mean age was 64.9 ± 9.1 years, 90.7% males. The whole artery 18F-FDG uptake was higher in the aorta than in the carotid arteries (median TBR 2.23, interquartile range [0.36] vs. 1.88 [0.42], p < 0.001); whereas uptake in the coronary arteries was lower than in the aorta or carotid arteries (1.13 [0.23], p < 0.001 both). Similarly, 18F-FDG uptake in the aortic MDS was higher than in the carotid MDS (2.75 [0.62] vs. 2.25 [0.63], p < 0.001); whereas 18F-FDG uptake in the coronary MDS was the lowest (1.40 [0.33], p < 0.001 both). These findings were consistent in both ACS and chronic CAD patients. The whole artery 18F-FDG uptake of the aorta and carotid arteries correlated in patients with ACS (r = 0.58, p = 0.002), but not in patients with chronic CAD (r = 0.21, p = 0.3). There was no correlation between the whole artery 18F-FDG uptake in the coronary arteries and either the aorta or carotid arteries in the whole cohort (r=-0.16, p = 0.2, r = 0.01, p = 0.9, respectively), in patients with ACS (r = 0.06, p = 0.7, r=-0.01, p = 0.9, respectively), or in those with chronic CAD (r=-0.4, p = 0.1, r=-0.09, p = 0.7, respectively). Conclusions In patients with ACS or chronic CAD, large arteries had higher 18F-FDG uptake than the coronary arteries. The intensity of 18F-FDG uptake in the coronary arteries did not correlate with that in the carotid arteries or the aorta, indicating that disease activity differs between large arteries and coronary arteries.

scholarly journals Is there a link between very early changes of primary and secondary lymphoid organs in 18F-FDG-PET/MRI and treatment response to checkpoint inhibitor therapy?

2020 ◽  
Vol 8 (2) ◽  
pp. e000656 ◽  
Author(s):  
Ferdinand Seith ◽  
Andrea Forschner ◽  
Benjamin Weide ◽  
Brigitte Gückel ◽  
Martin Schwartz ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Treatment Response ◽  
Fdg Pet ◽  
Checkpoint Inhibitor ◽  
Correlation Coefficients ◽  
Lymphoid Organs ◽  
Response Evaluation ◽  
Fdg Uptake ◽  
Checkpoint Inhibitor Therapy ◽  
Secondary Lymphoid Organs

Response assessment or prediction to checkpoint inhibitor therapy (CIT) is an unsolved problem in current routine diagnostics of patients with melanoma. Here, we evaluated very early changes of primary and secondary lymphoid organs under CIT in multiparametric [18F]-labeled fluorodeoxyglucose-positron emission tomography (18F-FDG-PET)/MRI as possible predictors of treatment response and investigated their correlation with baseline blood immune biomarkers. Between October 2014 and November 2017, 17 patients with unresectable melanoma (8 females; 65±11 years) undergoing CIT were prospectively evaluated using whole-body 18F-FDG-PET/MRI before CIT start (t0), 2 weeks (t1) and 3 months after CIT initiation (t2). At each time point, the volume, the 18F-FDG-uptake and the mean apparent diffusion coefficient (ADC) of the spleen as well as the 18F-FDG uptake of the bone marrow were assessed. Relative lymphocyte count (RLC), relative eosinophil count (REC) and neutrophil-lymphocyte ratio (NLR) were assessed at baseline. Response Evaluation Criteria in Solid Tumours modified for immune-based therapeutics (iRECIST) and decisions from an interdisciplinary tumor board were used for treatment response evaluation at t2. iRECIST was compared with PET response criteria in solid tumors for image-based response evaluation at different time points. Comparative analysis was conducted with Mann-Whitney U test with false discovery rate correction for multiple testing and correlation coefficients were computed. In lymphoid organs, significant differences (p<0.05) between responders (9/17) and non-responders were found for the 18F-FDG-uptake in the spleen at t1 and the increase of the uptake t1-t0 (responders/non-responders: standardized uptake value lean body mass 1.19/0.93; +49%/−1%). The best correlation coefficients to baseline biomarkers were found for the 18F-FDG-uptake in the spleen at t1: NLR, r=−0.46; RLC, r=0.43; REC, r=0.58 (p<0.05), respectively. Compared with the non-responder group, the responder group showed marked increases also in the volume of the spleen (+22%/+10%), the 18F-FDG-uptake of bone marrow (+31%/−9%) at t1 and the ADCmean at t2 (+46%/+15%) compared with t0, however, not reaching significance. Our findings indicate that an effective systemic immune response in patients undergoing CIT can be detected as a significantly increased spleen activity in 18F-FDG-PET as early as 2 weeks after treatment initiation.Trial registration numberNCT03132090, DRKS00013925.

PS02.110: PREDICTION OF PROGNOSIS BY EVALUATING RELATIVE CHANGE IN FDG-UPTAKE OF THE METASTATIC LYMPH NODES AFTER NEOADJUVANT CHEMOTHERAPY IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Shigefumi Yoshino ◽  
Shigeru Takeda ◽  
Shinsuke Kanekiyo ◽  
Masahiro Kitahara ◽  
Mitsuo Nishiyama ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Fdg Pet ◽  
Multivariate Analyses ◽  
Primary Tumors ◽  
Fdg Uptake ◽  
Before And After ◽  
Relative Change

Abstract Background Prognosis of patients with esophageal squamous cell carcinoma (ESCC) can be significantly improved by neoadjuvant chemotherapy (NAC). The current best clinical method to predict pathologic response of chemotherapy is the maximum standardized uptake value (SUVmax) in 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET). However, most of the FDG-PET evaluation has been focused on the primary tumors, but not on other metastatic lesions. The aim of this study was to determine the predictive value of FDG-uptake measured prior and after NAC both in the primary tumors and in the metastatic lymph modes (mLN) in ESCC. Methods Forty-five consecutive potentially resectable ESCC patients treated with NAC, which consisted of 2 courses of continuous infusion of 5-FU for days 1–5 and CDDP on day 1, between 2009 and 2016 were evaluated. FDG-uptake was measured at baseline and after chemotherapy in the primary tumors and in the mLN, and all patients underwent esophagectomy with R0 resection. The predictive values of FDG-PET and clinicopathological characteristics were determined with univariate and multivariate analyses. Results The median age was 66 years, with 35 males and 9 females. Pretreatment clinical classification of tumor depth was T1 in 9, T2 in 10, T3 in 26, respectively, and that of lymph modes metastases was N0 in 9, N1 in 12, N2 in 18, N3 in 6, respectively. The average SUVmax before and after NAC in the primary tumors was 13.9 and 7.9, respectively, and the average SUVmax reduction was 39.8% after chemotherapy. Pathological response was found to correlate well with the SUVmax reduction in the primary tumors, however, relative change in FDG uptake after chemotherapy was not associated with overall survival (OS). The average SUVmax before and after NAC in the mLN was 6.9 and 3.3, respectively, and the average SUVmax reduction was 46.2% after chemotherapy. Univariate and multivariate analyses revealed that both of the SUVmax and relative change in FDG uptake after chemotherapy in the mLN were well correlated with OS. Conclusion Post-NAC SUVmax and relative change in FDG uptake after chemotherapy in the mLN are valuable independent preoperative predictor of prognosis for patients with ESCC who received chemotherapy before surgery. Disclosure All authors have declared no conflicts of interest.

scholarly journals Thyroid lesions incidentally detected by 18F-FDG PET-CT ― a two centre retrospective study

2015 ◽  
Vol 49 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Jan Jamsek ◽  
Ivana Zagar ◽  
Simona Gaberscek ◽  
Marko Grmek
Keyword(s):  
Fdg Pet ◽  
Malignant Lesion ◽  
Standardized Uptake Value ◽  
Benign Lesions ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Thyroid Uptake ◽  
Malignant Lesions ◽  
Fdg Pet Ct ◽  
Thyroid Lesions

AbstractBackground. Incidental18F-FDG uptake in the thyroid on PET-CT examinations represents a diagnostic challenge. The maximal standardized uptake value (SUVmax) is one possible parameter that can help in distinguishing between benign and malignant thyroid PET lesions.Patients and methods. We retrospectively evaluated18F-FDG PET-CT examinations of 5,911 patients performed at two different medical centres from 2010 to 2011. If pathologically increased activity was accidentally detected in the thyroid, the SUVmaxof the thyroid lesion was calculated. Patients with incidental18F-FDG uptake in the thyroid were instructed to visit a thyroidologist, who performed further investigation including fine needle aspiration cytology (FNAC) if needed. Lesions deemed suspicious after FNAC were referred for surgery.Results. Incidental18F-FDG uptake in the thyroid was found in 3.89% ― in 230 out of 5,911 patients investigated on PET-CT. Malignant thyroid lesions (represented with focal thyroid uptake) were detected in 10 of 66 patients (in 15.2%). In the first medical centre the SUVmaxof 36 benign lesions was 5.6 ± 2.8 compared to 15.8 ± 9.2 of 5 malignant lesions (p < 0.001). In the second centre the SUVmaxof 20 benign lesions was 3.7 ± 2.2 compared to 5.1 ± 2.3 of 5 malignant lesions (p = 0.217). All 29 further investigated diffuse thyroid lesions were benign.Conclusions. Incidental18F-FDG uptake in the thyroid was found in 3.89% of patients who had a PET-CT examination. Only focal thyroid uptake represented a malignant lesion in our study ― in 15.2% of all focal thyroid lesions. SUVmaxshould only serve as one of several parameters that alert the clinician on the possibility of thyroid malignancy.

scholarly journals Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiping Shi ◽  
Lian Xu ◽  
Yinjie Zhu ◽  
Yining Wang ◽  
Ruohua Chen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Node Metastases ◽  
Ct Data ◽  
Fdg Pet Ct

PurposeDifferentiating lymph node metastases (LNM) from peripheral ganglia by physiological prostate-specific membrane antigen (PSMA) uptake is challenging. Two tracers (68Ga-PSMA-11 and 18F-fluorodeoxyglucose [FDG]) metabolic uptake patterns were evaluated by positron emission tomography-computed tomography (PET-CT), searching for differences that could tell ganglia from LNM.MethodsDual 68Ga-PSMA-11 and 18F-FDG PET-CT data of 138 prostate cancer patients acquired from June 2018 to December 2019 were retrospectively evaluated. Ganglia and LNM with PSMA-11 uptake above local background were analyzed by the location and PSMA-11-PET and FDG-PET maximum standardized uptake value (SUVmax).ResultsPSMA-11-positive ganglia (n = 381) and LNM (n = 83) were identified in 138 and 58 patients, respectively. The LNM SUVmax of PSMA-11-PET (16.4 ± 14.8 vs 2.3 ± 0.7, P &lt; 0.001) and FDG-PET (3.3 ± 3.2 vs 1.5 ± 0.5, P &lt; 0.001) were higher than in ganglia. The probabilities of being an LNM in the low-potential (PSMA-11-PET SUVmax of &lt;4.1 and FDG-PET SUVmax of &lt;2.05), moderate-potential (PSMA-11-PET SUVmax of &gt;4.1 and FDG-PET SUVmax of &lt;2.05, or PSMA-11-PET SUVmax of &lt;4.1 and FDG-PET SUVmax of &gt;2.05), and high-potential (PSMA-11-PET SUVmax of &gt;4.1 and FDG-PET SUVmax of &gt;2.05) groups were 0.9% (3/334), 44.6% (37/83), and 91.5% (43/47), respectively (P &lt; 0.001). The cervical and coeliac ganglia had higher PSMA-11 and FDG uptake than the sacral ganglia (P &lt; 0.001 for all). LNM PSMA-11 and FDG uptake was similar in these three locations.ConclusionThe FDG-PET and PSMA-11-PET SUVmax, especially when combined, could well differentiate LNM from ganglia. The tracers uptake differed between cervical/coeliac and sacral ganglia, so the lesion location should be considered during image assessment.

scholarly journals Lateralized periodic discharges frequency correlates with glucose metabolism

Neurology ◽  
2019 ◽  
Vol 92 (7) ◽  
pp. e670-e674 ◽  
Author(s):  
Thanujaa Subramaniam ◽  
Aditya Jain ◽  
Lance T. Hall ◽  
Andrew J. Cole ◽  
M. Brandon Westover ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Fdg Pet ◽  
Medical Records ◽  
Standardized Uptake Value ◽  
Continuous Variable ◽  
Continuous Measure ◽  
Categorical Variable ◽  
Fdg Uptake ◽  
Periodic Discharges ◽  
Structural Lesion

ObjectiveTo investigate the correlation between characteristics of lateralized periodic discharges (LPDs) and glucose metabolism measured by 18F-fluorodeoxyglucose (FDG)–PET.MethodsWe retrospectively reviewed medical records to identify patients who underwent FDG-PET during EEG monitoring with LPDs present during the FDG uptake period. Two blinded board-certified neurophysiologists independently interpreted EEGs. FDG uptake was measured using standardized uptake value (SUV). Structural images were fused with PET images to aid with localization of SUV. Two PET readers independently measured maximum SUV. Relative SUV values were obtained by normalization of the maximum SUV to the SUV of pons (SUVRpons). LPD frequency was analyzed both as a categorical variable and as a continuous measure. Other secondary variables included duration, amplitude, presence of structural lesion, and “plus” EEG features such as rhythmic or fast sharp activity.ResultsNine patients were identified and 7 had a structural etiology for LPDs. Analysis using frequency as a categorical variable and continuous variable showed an association between increased LPD frequency and increased ipsilateral SUVRpons (p = 0.02). Metabolism associated with LPDs (0.5 Hz as a baseline) increased by a median of 100% at 1 Hz and for frequencies >1 Hz increased by a median of 309%. There were no statistically significant differences in SUVRpons for other factors including duration (p = 0.10), amplitude (p = 0.80), structural etiology (p = 0.55), or “plus” features such as rhythmic or fast sharp activity (p = 0.84).ConclusionsMetabolic activity increases monotonically with LPD frequency. LPD frequency should be a measure of interest when developing neuroprotection strategies in critical neurologic illness.

Sign in / Sign up

Export Citation Format

Share Document