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Usefulness of C-11-methionine-positron emission tomography for the diagnosis of progressive multifocal leukoencephalopathy

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Title: Usefulness of C-11-methionine-positron emission tomography for the diagnosis of progressive multifocal leukoencephalopathy
Authors: Shirai, Shinichi Browse this author
Yabe, Ichiro Browse this author →KAKEN DB
Kano, Takahiro Browse this author
Shimizu, Yuka Browse this author
Sasamori, Toru Browse this author
Sato, Kazunori Browse this author
Hirotani, Makoto Browse this author →KAKEN DB
Nonaka, Takayuki Browse this author
Takahashi, Ikuko Browse this author
Matsushima, Masaaki Browse this author
Minami, Naoya Browse this author
Nakamichi, Kazuo Browse this author →KAKEN DB
Saijo, Masayuki Browse this author
Hatanaka, Kanako C. Browse this author
Shiga, Tohru Browse this author →KAKEN DB
Tanaka, Shinya Browse this author →KAKEN DB
Sasaki, Hidenao Browse this author →KAKEN DB
Keywords: Progressive multifocal leukoencephalopathy
C-11-methionine-positron emission tomography
F-18-fluorodeoxyglucose-positron emission tomography
Mefloquine
Issue Date: Dec-2014
Publisher: Springer
Journal Title: Journal of neurology
Volume: 261
Issue: 12
Start Page: 2314
End Page: 2318
Publisher DOI: 10.1007/s00415-014-7500-y
PMID: 25223960
Abstract: Progressive multifocal leukoencephalopathy (PML) is a subacute demyelinating disease of the brain caused by the JC virus that occurs mainly in immunocompromised patients. The prognosis is very poor. As the lesion looks like non- specific leukoencephalopathy, making a diagnosis at the early stage is very difficult. We report three PML cases in which there was a mismatch between C-11-methionine-positron emission tomography (MET-PET) uptake and F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) uptake. All three cases demonstrated the hyper-uptake of MET around the white matter lesions and hypo-uptake of FDG inside the lesions. We speculate that the infection had ended inside the white matter lesions of these patients, while JC virus infection was ongoing around the lesions, resulting in the increase of methionine metabolism, and the glucose metabolism was reduced or intermediate because inflammatory cells infiltrate PML lesions rarely. Two patients who were diagnosed and treated with mefloquine while the JC virus was at a low level in the cerebrospinal fluid are still alive. We suggest the usefulness of MET-PET for the early diagnosis of PML and early treatment with mefloquine.
Rights: The final publication is available at link.springer.com
Type: article (author version)
URI: http://hdl.handle.net/2115/60294
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 矢部 一郎

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