Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patterns

Clinical assessment of frontotemporal lobar degeneration (FTLD)/primary progressive aphasia (PPA) patients is challenging, given that common cognitive assessments rely extensively on language. Since asymmetry in neuroimaging biomarkers is often described as a central finding in these patients, our s...

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Main Authors: Ana M. Franceschi, Kiyon Naser-Tavakolian, Michael Clifton, Lev Bangiyev, Giuseppe Cruciata, Sean Clouston, Dinko Franceschi
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-07-01
Series:World Journal of Nuclear Medicine
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/wjnm.wjnm_137_20
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author Ana M. Franceschi
Kiyon Naser-Tavakolian
Michael Clifton
Lev Bangiyev
Giuseppe Cruciata
Sean Clouston
Dinko Franceschi
author_facet Ana M. Franceschi
Kiyon Naser-Tavakolian
Michael Clifton
Lev Bangiyev
Giuseppe Cruciata
Sean Clouston
Dinko Franceschi
author_sort Ana M. Franceschi
collection DOAJ
description Clinical assessment of frontotemporal lobar degeneration (FTLD)/primary progressive aphasia (PPA) patients is challenging, given that common cognitive assessments rely extensively on language. Since asymmetry in neuroimaging biomarkers is often described as a central finding in these patients, our study evaluated [18F]-fluorodeoxyglucose (FDG) uptake patterns in patients meeting clinical and imaging criteria for FTLD, with emphasis on PPA. Fifty-one subjects underwent brain [18F]-FDG positron-emission tomography/magnetic resonance imaging (PET/MRI) as part of their routine clinical workup for dementia and neurodegenerative disease. Images were obtained using a Siemens Biograph mMR integrated 3T PET/MRI scanner. PET surface maps and fusion fluid-attenuated inversion recovery-PET images were generated utilizing MIMneuro software. Two board-certified neuroradiologists and one nuclear medicine physician blinded to patient history classified each FTLD/PPA subtype and assessed for left- versus right-side dominant hypometabolism. Qualitative and semiquantitative assessment demonstrated 18 cases of PPA, 16 behavioral variant frontotemporal dementia (bvFTD), 12 corticobasal degeneration, and 5 progressive supranuclear palsy. Among the 18 PPA subjects (11 svPPA, 5 lvPPA, and 2 agPPA), 12 (67%) demonstrated left-dominant hypometabolism and 6 (33%) right-dominant hypometabolism. While existing literature stresses left-dominant hypometabolism as a key imaging feature in the PPA subtypes, a third of our cases demonstrated right-dominant hypometabolism, suggesting that emphasis should be placed on the functionality of specific brain regions affected, rather than left versus right sidedness of hypometabolism patterns.
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spelling doaj-art-adc3cb796ba64be9b9436602fff664862025-08-20T02:54:42ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122021-07-01200329430410.4103/wjnm.wjnm_137_20Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patternsAna M. Franceschi0Kiyon Naser-Tavakolian1Michael Clifton2Lev Bangiyev3Giuseppe Cruciata4Sean Clouston5Dinko Franceschi6Department of Radiology, Neuroradiology Section, Northwell Health/Donald and Barbara Zucker School of Medicine, Manhasset, Stony Brook, NY, USADepartments of Radiology and Family and Population and Preventive Medicine, SUNY Stony Brook, Stony Brook, NY, USADepartments of Radiology and Family and Population and Preventive Medicine, SUNY Stony Brook, Stony Brook, NY, USADepartments of Radiology and Family and Population and Preventive Medicine, SUNY Stony Brook, Stony Brook, NY, USADepartments of Radiology and Family and Population and Preventive Medicine, SUNY Stony Brook, Stony Brook, NY, USADepartments of Population and Preventive Medicine, SUNY Stony Brook, Stony Brook, NY, USADepartments of Radiology and Family and Population and Preventive Medicine, SUNY Stony Brook, Stony Brook, NY, USAClinical assessment of frontotemporal lobar degeneration (FTLD)/primary progressive aphasia (PPA) patients is challenging, given that common cognitive assessments rely extensively on language. Since asymmetry in neuroimaging biomarkers is often described as a central finding in these patients, our study evaluated [18F]-fluorodeoxyglucose (FDG) uptake patterns in patients meeting clinical and imaging criteria for FTLD, with emphasis on PPA. Fifty-one subjects underwent brain [18F]-FDG positron-emission tomography/magnetic resonance imaging (PET/MRI) as part of their routine clinical workup for dementia and neurodegenerative disease. Images were obtained using a Siemens Biograph mMR integrated 3T PET/MRI scanner. PET surface maps and fusion fluid-attenuated inversion recovery-PET images were generated utilizing MIMneuro software. Two board-certified neuroradiologists and one nuclear medicine physician blinded to patient history classified each FTLD/PPA subtype and assessed for left- versus right-side dominant hypometabolism. Qualitative and semiquantitative assessment demonstrated 18 cases of PPA, 16 behavioral variant frontotemporal dementia (bvFTD), 12 corticobasal degeneration, and 5 progressive supranuclear palsy. Among the 18 PPA subjects (11 svPPA, 5 lvPPA, and 2 agPPA), 12 (67%) demonstrated left-dominant hypometabolism and 6 (33%) right-dominant hypometabolism. While existing literature stresses left-dominant hypometabolism as a key imaging feature in the PPA subtypes, a third of our cases demonstrated right-dominant hypometabolism, suggesting that emphasis should be placed on the functionality of specific brain regions affected, rather than left versus right sidedness of hypometabolism patterns.http://www.thieme-connect.de/DOI/DOI?10.4103/wjnm.wjnm_137_20[18f]-fluorodeoxyglucosefrontotemporal lobar degenerationhybrid neuroimagingpositron emission tomography/magnetic resonance imagingprimary progressive aphasia
spellingShingle Ana M. Franceschi
Kiyon Naser-Tavakolian
Michael Clifton
Lev Bangiyev
Giuseppe Cruciata
Sean Clouston
Dinko Franceschi
Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patterns
World Journal of Nuclear Medicine
[18f]-fluorodeoxyglucose
frontotemporal lobar degeneration
hybrid neuroimaging
positron emission tomography/magnetic resonance imaging
primary progressive aphasia
title Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patterns
title_full Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patterns
title_fullStr Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patterns
title_full_unstemmed Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patterns
title_short Metabolic positron-emission tomography/magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes: Reassessment of expected [18F]-fluorodeoxyglucose uptake patterns
title_sort metabolic positron emission tomography magnetic resonance imaging in primary progressive aphasia and frontotemporal lobar degeneration subtypes reassessment of expected 18f fluorodeoxyglucose uptake patterns
topic [18f]-fluorodeoxyglucose
frontotemporal lobar degeneration
hybrid neuroimaging
positron emission tomography/magnetic resonance imaging
primary progressive aphasia
url http://www.thieme-connect.de/DOI/DOI?10.4103/wjnm.wjnm_137_20
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