Volume 146, Issue 6 pp. 708-715
REVIEW ARTICLE

Positron emission tomography in autoimmune encephalitis: Clinical implications and future directions

Gongfei Li

Gongfei Li

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

China National Clinical Research Center for Neurological Diseases, Beijing, China

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Xiao Liu

Xiao Liu

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

China National Clinical Research Center for Neurological Diseases, Beijing, China

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Tingting Yu

Tingting Yu

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

China National Clinical Research Center for Neurological Diseases, Beijing, China

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Jiechuan Ren

Jiechuan Ren

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

China National Clinical Research Center for Neurological Diseases, Beijing, China

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Qun Wang

Corresponding Author

Qun Wang

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

China National Clinical Research Center for Neurological Diseases, Beijing, China

Beijing Institute for Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China

Correspondence

Qun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.

Email: [email protected]

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First published: 19 October 2022
Citations: 10

Funding information

The National Key Program of China (2022YFC2503800, 2017YFC1307500), the Capital Healthy Development Research Funding (2016-1-2011, 2020-1-2013), and the Beijing Natural Science Foundation (Z200024).

Abstract

18F-fluoro-deoxyglucose position emission tomography (18F-FDG-PET) has been proven as a sensitive and reliable tool for diagnosis of autoimmune encephalitis (AE). More attention was paid to this kind of imaging because of the shortage of MRI, EEG, and CSF findings. FDG-PET has been assessed in a few small studies and case reports showing apparent abnormalities in cases where MRI does not. Here, we summarized the patterns (specific or not) in AE with different antibodies detected and the clinical outlook for the wide application of FDG-PET considering some limitations. Specific patterns based on antibody subtypes and clinical symptoms were critical for identifying suspicious AE, the most common of which was the anteroposterior gradient in anti- N -methyl- d -aspartate receptor (NMDAR) encephalitis and the medial temporal lobe hypermetabolism in limbic encephalitis. And the dynamic changes of metabolic presentations in different phases provided us the potential to inspect the evolution of AE and predict the functional outcomes. Except for the visual assessment, quantitative analysis was recently reported in some voxel-based studies of regions of interest, which suggested some clues of the future evaluation of metabolic abnormalities. Large prospective studies need to be conducted controlling the time from symptom onset to examination with the same standard of FDG-PET scanning.

CONFLICT OF INTEREST

All authors declare that they have no competing interest.

DATA AVAILABILITY STATEMENT

Data supporting this article will be made available by the authors, without undue reservation.

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