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Brain 18F-FDG PET for the diagnosis of autoimmune encephalitis: a systematic review and a meta-analysis

European Journal of Nuclear Medicine and Molecular Imaging volume 48, pages 3847–3858 (2021)Cite this article

Abstract

Objective

To consolidate current understanding of detection sensitivity of brain 18F-FDG PET scans in the diagnosis of autoimmune encephalitis and to define specific metabolic imaging patterns for the most frequently occurring autoantibodies.

Methods

A systematic and exhaustive search of data available in the literature was performed by querying the PubMed/MEDLINE and Cochrane databases for the search terms: ((PET) OR (positron emission tomography)) AND ((FDG) OR (fluorodeoxyglucose)) AND ((encephalitis) OR (brain inflammation)). Studies had to satisfy the following criteria: (i) include at least ten pediatric or adult patients suspected or diagnosed with autoimmune encephalitis according to the current recommendations, (ii) specifically present 18F-FDG PET and/or morphologic imaging findings. The diagnostic 18F-FDG PET detection sensitivity in autoimmune encephalitis was determined for all cases reported in this systematic review, according to a meta-analysis following the PRISMA method, and selected publication quality was assessed with the QUADAS-2 tool.

Results

The search strategy identified 626 articles including references from publications. The detection sensitivity of 18F-FDG PET was 87% (80–92%) based on 21 publications and 444 patients included in the meta-analysis. We also report specific brain 18F-FDG PET imaging patterns for the main encephalitis autoantibody subtypes.

Conclusion and relevance

Brain 18F-FDG PET has a high detection sensitivity and should be included in future diagnostic autoimmune encephalitis recommendations. Specific metabolic 18F-FDG PET patterns corresponding to the main autoimmune encephalitis autoantibody subtypes further enhance the value of this diagnostic.

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The data that support the findings of this study are available on request from the corresponding author (AV).

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Affiliations

  1. Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, Rue du Morvan, 54500 Vandoeuvre-les-Nancy, F-54000, Nancy, France

    Manon Bordonne, Mohammad B. Chawki, Matthieu Doyen & Antoine Verger

  2. Université de Lorraine, IADI, INSERM U1254, F-54000, Nancy, France

    Matthieu Doyen & Antoine Verger

  3. Nuclear Medicine Department, Pitié-Salpêtrière Hospital, APHP Sorbonne-Université, Laboratoire d’Imagerie Biomédicale, Sorbonne Université, F-75000, Paris, France

    Aurelie Kas

  4. Nuclear Medicine Department, Aix Marseille Univ, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, F-13000, Marseille, France

    Eric Guedj

  5. Department of Neurology, Université de Lorraine, CRAN UMR 7039, CHRU, F-54000, Nancy, France

    Louise Tyvaert

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  1. Manon Bordonne
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Contributions

All authors contributed significantly to the analysis and interpretation of the data (MB, MD, MBC, AV), to the writing of the manuscript (EM, AV) and to the revision of the manuscript (EG, AK, LT, AV).

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Correspondence to Antoine Verger.

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The consent has been obtained for each patient for whom their FDG PET images are included in the manuscript.

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The authors declare no competing interests.

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Bordonne, M., Chawki, M.B., Doyen, M. et al. Brain 18F-FDG PET for the diagnosis of autoimmune encephalitis: a systematic review and a meta-analysis. Eur J Nucl Med Mol Imaging 48, 3847–3858 (2021). https://doi.org/10.1007/s00259-021-05299-y

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Keywords

  • Meta-analysis
  • Autoimmune encephalitis
  • Brain 18F-FDG PET
  • Autoantibody