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Master Thesis

Profil métabolique de l’angiopathie amyloïde cérébrale en TEP-TDM cérébrale au 18F-FDG

Abstract : Background: The clinical diagnosis of cerebral amyloid angiopathy (CAA) is currently based on the Boston criteria, which mainly rely on brain MRI features. Adding FDG PET to these criteria might improve their accuracy. To date, however, brain FDG uptake in probable CAA has not been systematically investigated. We hypothesized that brain FDG uptake would be significantly reduced in posterior cortical areas, particularly the primary occipital cortex, which pathologically bear the brunt of vascular Aβ deposition. Methods: From a large memory clinic database, we retrospectively included 14 patients in whom both brain MRI and FDG PET had been obtained as part of routine clinical care and who fulfilled the Boston criteria for probable CAA (≥2 exclusively lobar microbleeds). None had a history of symptomatic intracerebral hemorrhage (sICH). FDG data processing involved i) spatial normalization to the MNI152 space, and ii) generation of standardized FDG uptake (SUVr; relative to the pons) Z-scores relative to healthy age-matched controls for a template of 13 regions-of-interest (ROIs) covering the whole cortex and the cerebellum. The presence of significant hypometabolism (two-tailed p<0.05) was then assessed for the bilaterally-averaged ROI SUVr. Results: Significant hypometabolism (p range: 0.047 to 0.001) was present across all ROIs except anterior-most ROIs. Posterior cortical areas were the most affected, with in decreasing order of statistical significance the inferior parietal, primary visual, superior parietal, lateral occipital, lateral temporal, precuneus and posterior cingulate ROIs. Conclusions: Supporting our hypothesis, glucose hypometabolism affected predominantly posterior cortical regions, including the primary visual cortex, which pathologically are prominently affected in CAA. Given the small sample and retrospective analysis from a memory clinic, these results need replication and may not necessarily generalize to CAA-related sICH.
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Master Thesis
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Submitted on : Monday, April 26, 2021 - 4:20:56 PM
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Sébastien Bergeret. Profil métabolique de l’angiopathie amyloïde cérébrale en TEP-TDM cérébrale au 18F-FDG. Médecine humaine et pathologie. 2020. ⟨dumas-03208580⟩



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