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Amino Acid Uptake, Glucose Metabolism, and Neuroinflammation in John Cunningham Virus Associated Progressive Multifocal Leukoencephalopathy.

Clin Nucl Med. 2022 Feb 21. doi: 10.1097/RLU.0000000000004093. Epub ahead of print. PMID: 35195584.

Authors/Editors: Unterrainer M, Mahler C, Schumacher AM, Ruf V, Blum B, Quach S, Brendel M, Rupprecht R, Bartenstein P, Kerschensteiner M, Kümpfel T, Albert NL.
Publication Date: 2022

Abstract

A 69-year-old woman presented with progressive dysarthria and cognitive deficits. On MRI, a T2-hyperintense, non–contrast-enhancing lesion was found in the left precentral area. 18F-FET and 18F-FDG PET scans revealed faint amino acid uptake and glucose hypometabolism of the lesion. To assess a neuroinflammatory component, TSPO PET with 18F-GE-180 was performed, where tracer uptake markedly exceeded the T2-hyperintense areas. Histology derived from a stereotactic biopsy findings confirmed John Cunningham virus–associated progressive multifocal leukoencephalopathy. This case underlines that TSPO PET comprises distinct imaging advantages over other established radioligands such as 18F-FET and 18F-FDG in progressive multifocal leukoencephalopathy.

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