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

• Published in: European journal of nuclear medicine and molecular imaging Vol. 48; no. 12; pp. 3847 - 3858
• Main Authors: Bordonne, Manon, Chawki, Mohammad B., Doyen, Matthieu, Kas, Aurelie, Guedj, Eric, Tyvaert, Louise, Verger, Antoine
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2021; Springer Nature B.V; Springer Verlag (Germany) [1976-....]
• Subjects: Autoantibodies; Autoimmune diseases; Bioengineering; Brain; Cardiology; Computer Science; Data search; Diagnosis; Documents; Emission analysis; Encephalitis; Fluorine isotopes; Human health and pathology; Imaging; Life Sciences; Medical diagnosis; Medical Imaging; Medicine; Medicine & Public Health; Meta-analysis; Metabolism; Neuroimaging; Neurology; Nuclear Medicine; Oncology; Orthopedics; Patients; Pediatrics; Positron emission; Positron emission tomography; Quality assessment; Radiology; Review Article; Search methods; Systematic review; Tomography; F-FDG PET; Autoantibody; Brain; Meta-analysis; Autoimmune encephalitis; Brain 18F-FDG PET
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-021-05299-y

Objective
To consolidate current understanding of detection sensitivity of brain
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F-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
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F-FDG PET and/or morphologic imaging findings. The diagnostic
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F-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
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F-FDG PET was 87% (80–92%) based on 21 publications and 444 patients included in the meta-analysis. We also report specific brain
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F-FDG PET imaging patterns for the main encephalitis autoantibody subtypes.
Conclusion and relevance
Brain
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F-FDG PET has a high detection sensitivity and should be included in future diagnostic autoimmune encephalitis recommendations. Specific metabolic
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F-FDG PET patterns corresponding to the main autoimmune encephalitis autoantibody subtypes further enhance the value of this diagnostic.