FDG-PET imaging in mild traumatic brain injury: a critical review

Abstract

Traumatic brain injury (TBI) affects an estimated 1.7 million people in the United States and is a contributing factor to one third of all injury related deaths annually. According to the CDC, approximately 75% of all reported TBIs are concussions or considered mild in form, although the number of unreported mild TBIs (mTBI) and patients not seeking medical attention is unknown. Currently, classification of mTBI or concussion is a clinical assessment since diagnostic imaging is typically inconclusive due to subtle, obscure, or absent changes in anatomical or physiological parameters measured using standard magnetic resonance (MR) or computed tomography (CT) imaging protocols. Molecular imaging techniques that examine functional processes within the brain, such as measurement of glucose uptake and metabolism using [18F]fluorodeoxyglucose and positron emission tomography (FDG-PET), have the ability to detect changes after mTBI. Recent technological improvements in the resolution of PET systems, the integration of PET with magnetic resonance imaging (MRI), and the availability of normal healthy human databases and commercial image analysis software contribute to the growing use of molecular imaging in basic science research and advances in clinical imaging. This review will discuss the technological considerations and limitations of FDG-PET, including differentiation between glucose uptake and glucose metabolism and the significance of these measurements. In addition, the current state of FDG-PET imaging in assessing mTBI in clinical and preclinical research will be considered. Finally, this review will provide insight into potential critical data elements and recommended standardization to improve the application of FDG-PET to mTBI research and clinical practice.

Subacute administration of fluoxetine prevents short-term brain hypometabolism and reduces brain damage markers induced by the lithium-pilocarpine model of epilepsy in rats

“…2B) in a similar way that the above reports. Regarding the metabolism quantifier, currently the most widely used quantification index in small-animal [ 18 F] FDG PET studies is the semi-quantitative SUV measure (Byrnes et al, 2014;Deleye et al, 2014). In order to avoid an eventual SUV inter-scan variation, comparisons of [ 18 F] FDG SUV values were performed not against basal acquisitions made at beginning of the study, but against the corresponding control groups (García-García et al, 2014).…”

In vivo continuous and simultaneous monitoring of brain energy substrates with a multiplex amperometric enzyme-based biosensor device

“…Ideally, biomonitoring of target analytes should be performed by non-invasive methods such as positron emitting tomography (PET), magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). However, these methods have severe limitations characterized by low quantitative resolution and limited temporal and/or spatial resolution (Byrnes et al, 2014;Haller et al, 2014;Lang et al, 2014;Li et al, 2013). Therefore invasive methods such as microdialysis and microbiosensors are needed for additional in situ information, such as basal levels and dynamic changes of each analyte in a discrete brain area.…”

Imaging Evidence and Recommendations for Traumatic Brain Injury: Advanced Neuro- and Neurovascular Imaging Techniques

“…[134][135][136][137][138] Recent literature reviews summarizing the possible utility of PET 139 and SPECT 140 in TBI, particularly mild TBI, have drawn this cohort data largely from cross-sectional designs with a smaller number of longitudinal studies also reviewed. Very few randomized controlled trials were discovered when examining the literature.…”