Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Nov;48(12):3847-3858.
doi: 10.1007/s00259-021-05299-y. Epub 2021 Mar 7.

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

Manon Bordonne  1 , Mohammad B Chawki  1 , Matthieu Doyen  1   2 , Aurelie Kas  3 , Eric Guedj  4 , Louise Tyvaert  5 , Antoine Verger  6   7
Affiliations
Meta-Analysis

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

Manon Bordonne et al. Eur J Nucl Med Mol Imaging. 2021 Nov.

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.

Keywords: Autoantibody; Autoimmune encephalitis; Brain 18F-FDG PET; Meta-analysis.

PubMed Disclaimer

References

    1. Graus F, Titulaer MJ, Balu R, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016;15(4):391–404. https://doi.org/10.1016/S1474-4422(15)00401-9 . - DOI - PubMed - PMC
    1. Jmor F, Emsley HC, Fischer M, Solomon T, Lewthwaite P. The incidence of acute encephalitis syndrome in Western industrialised and tropical countries. Virol J. 2008;5(1):134. https://doi.org/10.1186/1743-422X-5-134 . - DOI - PubMed - PMC
    1. Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013;12(2):157–65. https://doi.org/10.1016/S1474-4422(12)70310-1 . - DOI - PubMed - PMC
    1. Granerod J, Ambrose HE, Davies NW, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis. 2010;10(12):835–44. https://doi.org/10.1016/S1473-3099(10)70222-X . - DOI - PubMed
    1. Mailles A, Stahl J. Infectious encephalitis in France in 2007: a national prospective study. Clin Infect Dis. 2009;49(12):1838–47. https://doi.org/10.1086/648419 . - DOI - PubMed

Substances

Supplementary concepts

LinkOut - more resources