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Repeated fluorodeoxyglucose positron emission tomography of the brain in infants with suspected hypoxic-ischaemic brain injury

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Abstract

Positron emission tomography (PET) permits the study of cerebral metabolism in vivo. We performed repeated PET studies with fluorine-18 fluorodeoxyglucose (FDG) as a tracer to measure cerebral glucose metabolism for estimation of neurological prognosis in infants with suspected hypoxic-ischaemic brain injury. Fourteen infants (gestational age 35.3 ± 4.67 weeks) were examined during the neonatal period (at age 38.4±2.7 weeks) and again at the age of 3.5±0.7 months; one further infant was studied only once at the age of 2.5 months. All children also underwent ultrasound examinations. Electroencephalography and computed tomography or magnetic resonance imaging were performed according to their clinical condition and their neurological development has been followed. FDG accumulated most actively in the subcortical areas (thalami, brainstem and cerebellum) and the sensorimotor cortex during the neonatal period. The repeated PET study showed that the uptake of FDG was markedly high and increased in all brain sections of infants with normal development (n=11), whereas those with delayed development (n=4) had significantly lower values (P≤0.005).

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References

  1. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol 1976;33:696–705.

    Google Scholar 

  2. Fenichel GM. Hypoxic-ischemic encephalopathy in the newborn. Arch Neurol 1983;40:261–266.

    Google Scholar 

  3. Volpe JJ. Neurology of the newborn, 2nd edn. Philadelphia: W. B. Saunders, 1987.

    Google Scholar 

  4. Chugani HT, Phelps ME. Maturational changes in cerebral function in infants determined by 18FDG positron emission tomography. Science 1986;231:840–843.

    Google Scholar 

  5. Chugani HT, Phelps ME, Mazziotta JC. Positron emission tomography study of human brain functional development. Ann Neurol 1987;22:487–497.

    Google Scholar 

  6. Doyle LW, Nahmias C, Firnau G, et al. Regional cerebral glucose metabolism of newborn infants measured by positron emission tomography. Dev Med Child Neurol 1983;25:143–151.

    Google Scholar 

  7. Thorp PS, Levin SD, Garnett ES, et al. Patterns of cerebral glucose metabolism using 18FDG and positron emission tomography in the neurologic investigation of the full term newborn infant. Neuropediatrics 1988;19:146–153.

    Google Scholar 

  8. Volpe JJ, Herscovitch P, Perlman JM, Raichle ME. Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement. Pediatrics 1983;72:589–601.

    Google Scholar 

  9. Volpe JJ, Herscovitch P, Perlman JM, Kreusser KL, Raichle ME. Positron emission tomography in the asphyxiated term newborn: parasagittal impairment of cerebral blood flow. Ann Neurol 1985;17:287–296.

    Google Scholar 

  10. Perlman JM, Herscovitch P, Kreusser KL, et al. Positron emission tomography in the newborn: effect of seizure on regional cerebral blood flow in an asphyxiated infant. Neurology 1985;35:244–247.

    Google Scholar 

  11. Hope PL, Costello AMdeL, Cady EB, et al. Cerebral energy metabolism studied with phosphorus NMR spectroscopy in normal and birth-asphyxiated infants. Lancet 1984;11:366–370.

    Google Scholar 

  12. Azzopardi D, Wyatt S, Cady EB, et al. Prognosis of newborn infants with hypoxic-ischemic brain injury assessed by phosphorus magnetic resonance spectroscopy. Pediatr Res 1989;25:445–451.

    Google Scholar 

  13. Ruth V, Fyhrquist F, Clemons G, Raivio KO. Cord plasma vasopressin, erythropoietin, and hypoxanthine as indices of asphyxia at birth. Pediatr Res 1988;24:490–494.

    Google Scholar 

  14. Ruth V, Autti-Rämö I, Granström M-L, Korkman M, Raivio KO. Prediction of perinatal brain damage by cord plasma vasopressin, erythropoietin, and hypoxanthine. J Pediatr 1990;116:950–954.

    Google Scholar 

  15. Ruth V. Prognostic value of creatine kinase BB-isoenzyme in high-risk newborn infants. Arch Dis Child 1989;64:563–568.

    Google Scholar 

  16. Finer NN, Robertson CM, Richards RT, et al. Hypoxicischemic encephalopathy in term neonates: perinatal factors and outcome. J Pediatr 1981;98:112–117.

    Google Scholar 

  17. Dubowitz LMS, Palmer PG, Miller G, et al. Correlation of neurologic assessment in the preterm newborn infant with outcome at 1 year. J Pediatr 1984;105:452–456.

    Google Scholar 

  18. Levene MI, Sands C, Grindulis H, Moore JR. Comparison of two methods of predicting outcome in perinatal asphyxia. Lancet 1986;1:67–69.

    Google Scholar 

  19. Calame A, Fawer CL, Anderegg A, Perentes E. Interaction between perinatal brain damage and processes or normal brain development: ultrasonographic and neurodevelopmental study in the first year of life. Dev Neurosci 1985;7:1–11.

    Google Scholar 

  20. Adsett DB, Fitz CR, Hill A. Hypoxic-ischemic cerebral injury in the term newborn: correlation of CT findings with neurological outcome. Dev Child Neurol 1985;27:155–160.

    Google Scholar 

  21. Fitzharding PM, Flodmark O, Fitz CR, Ashby S. The prognostic value of computed tomography as an adjunct to assessment of the term infant with postasphyxial encephalopathy. J Pediatr 1981;99:777–781.

    Google Scholar 

  22. Steinlin M, Dirr R, Martin E, et al. MRI following severe perinatal asphyxia: preliminary experience. Pediatr Neurol 1991;7:164–170.

    Google Scholar 

  23. Spinks TJ, Jones T, Gilardi MC, Heather JD. Physical performance of the latest generation of commercial positron scanner. IEEE Trans Nucl Sci 1988;35:721–725.

    Google Scholar 

  24. Haaparanta M, Bergman J, Solin O, Roeda D. A remotely controlled system for the routine synthesis of 18F-2-fluoro-2-deoxy-d-glucose. Nuclearmedizin (Suppl) 1984;21:823–826.

    Google Scholar 

  25. Ruotsalainen U, Eronen E, Suhonen-Polvi H, Kinnala A, Teräs M, Wegelius U. Dosimetric measurements in [18F]FDG brain studies of newborn infants. In: Voipio-Pulkki L-M, Wegelius U, eds. Medical application of cyclotrons VI. Ann Univ Turkuensis 1992;88:A75–A76.

  26. Oldendorf WH. Expression of tissue isotope distribution. J Nucl Med 1975;16:958–959.

    Google Scholar 

  27. Woodard HQ, Bigler RB, Freed B, Russ G. Expression of tissue isotope distribution. J Nucl Med 1974;16:958–959.

    Google Scholar 

  28. Lindholm P, Minn H, Leskinen-Kallio S, Bergman J, Ruotsalainen U, Joensuu H. Influence of the blood glucose concentration on FDG uptake in cancer — a PET study. J Nucl Med 1993;34:1–6.

    Google Scholar 

  29. Kinnala A, Nuutila P, Ruotsalainen U, et al. Neonatal hypoglycaemia effects on cerebral glucose utilization in newborn infants: a [18F]FDG positron emission tomography (PET) study. In: Voipio-Pulkki L-M, Wegelius U, eds. Medical application of cyclotrons VI. Ann Univ Turkuensis 1992:88:A77–A78.

  30. Suhonen-Polvi H, Ruotsalainen U, Kero P, et al. Functional development of the brain during the first months of life: a [18F]FDG positron emission tomography study. Fetal Diagn Ther 1992;7:85.

    Google Scholar 

  31. Greisen G. Effect of cerebral blood flow and cerebrovascular autoregulation on the distribution, type and extent of cerebral injury. Brain Pathol 1992;2:223–228.

    Google Scholar 

  32. Vannucci RC. Cerebral carbohydrate and energy metabolism in perinatal hypoxic-ischemic brain damage. Brain Pathol 1992;2:229–234.

    Google Scholar 

  33. Chugani HT, Hovda DA, Villablanca JR, Villablanca JR, Phelps ME, Xu W-F. Metabolic maturation of the brain: a study of local cerebral utilization in the developing cat. J Cereb Blood Flow Metab 1991;11:35–47.

    Google Scholar 

  34. Rubinstein M, Denays R, Ham HR, et al. Functional imaging of brain maturation in humans using iodine-123 iodoamphetamine and SPECT. J Nucl Med 1989;30:1982–1985.

    Google Scholar 

  35. Denays R, Ham H, Tondeur M, Piepsz A, Noel P. Detection of bilateral and symmetrical anomalies in technetium-99m-HMPAO brain SPECT studies. J Nucl Med 1992;33:485–490.

    Google Scholar 

  36. Chiron C, Raynaud C, Maziere B, et al. Changes in regional cerebral blood flow during brain maturation in children and adolescents. J Nucl Med 1992;33:696–703.

    Google Scholar 

  37. Kraus H, Schlenker S, Schwedesky D. Developmental changes of cerebral ketone body utilization in human infants. Hoppe Seylers Z Physiol Chem 1974;355:164–170.

    Google Scholar 

  38. Blomstrand S, Karlsson K, Kjellmer I. Measurement of cerebral blood flow in the fetal lamb with a note on the flow-distribution. Acta Physiol Scand 1978;103:1–8.

    Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Turku University Central Hospital, SF-20520, Turku, Finland

    Hanna Suhonen-Polvi, Pentti Kero, Heikki Korvenranta & Olli Simell

  2. Turku Medical Cyclotron-PET Center, c/o Department of Nuclear Medicine, Turku University Central Hospital, SF-20520, Turku, Finland

    Hanna Suhonen-Polvi, Ulla Ruotsalainen & Uno Wegelius

  3. Turku Medical Cyclotron-PET Center, Radiochemistry Laboratory, Turku University, SF-20500, Turku, Finland

    Merja Haaparanta & Jörgen Bergman

Authors
  1. Hanna Suhonen-Polvi
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  2. Pentti Kero
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  3. Heikki Korvenranta
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  4. Ulla Ruotsalainen
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  5. Merja Haaparanta
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  6. Jörgen Bergman
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  7. Olli Simell
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  8. Uno Wegelius
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Correspondence to: H. Suhonen-Polvi

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Suhonen-Polvi, H., Kero, P., Korvenranta, H. et al. Repeated fluorodeoxyglucose positron emission tomography of the brain in infants with suspected hypoxic-ischaemic brain injury. Eur J Nucl Med 20, 759–765 (1993). https://doi.org/10.1007/BF00180905

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  • DOI: https://doi.org/10.1007/BF00180905

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