Impact of plasma glucose level on the pattern of brain FDG uptake and the predictive power of FDG PET in mild cognitive impairment

Apostolova, Ivayla; Lange, Catharina; Suppa, Per; Spies, Lothar; Klutmann, Susanne; Adam, Gerhard; Grothe, Michel J.; Buchert, Ralph

doi:10.1007/s00259-018-3985-4

Cited by 17 publications

(17 citation statements)

References 17 publications

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“…In our research, voxel-bases group comparison revealed hypometabolism in the region of the precuneus in the diabetic group compared to the obese. This could be in line with the results of Apostolova and co-authors who pointed out that elevated blood glucose level (98.4±15.8 mg/dl/5.5±0.88 mmol/L), even in the normal range (reference range 59–149 mg/dl/3.3-8.34 mmol/L) is associated with a decrease regarding [ 18 F]FDG uptake in the posterior cortex (Apostolova et al, 2018 ). Increasing plasma glucose levels causing reduced brain glucose metabolism in the region of the precuneus and the posterior cingulate gyrus detected by Ishibashi K and co-workers could also be in coherence with our result (Ishibashi et al, 2016 ).…”

Section: Discussionsupporting

confidence: 91%

Glucose-level dependent brain hypometabolism in type 2 diabetes mellitus and obesity

Képes

Aranyi

Forgács³

et al. 2021

European J Hybrid Imaging

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Background Metabolic syndrome and its individual components lead to wide-ranging consequences, many of which affect the central nervous system. In this study, we compared the [18F]FDG regional brain metabolic pattern of participants with type 2 diabetes mellitus (T2DM) and non-DM obese individuals. Methods In our prospective study, 51 patients with controlled T2DM (ages 50.6 ± 8.0 years) and 45 non-DM obese participants (ages 52.0 ± 9.6 years) were enrolled. Glucose levels measured before PET/CT examination (pre-PET glucose) as well as laboratory parameters assessing glucose and lipid status were determined. NeuroQ application (NeuroQTM 3.6, Syntermed, Philips) was used to evaluate regional brain metabolic differences. [18F]FDG PET/CT (AnyScan PC, Mediso) scans, estimating brain metabolism, were transformed to MNI152 brain map after T1 registration and used for SPM-based group comparison of brain metabolism corrected for pre-PET glucose, and correlation analysis with laboratory parameters. Results NeuroQ analysis did not reveal significant regional metabolic defects in either group. Voxel-based group comparison revealed significantly (PFWE<0.05) decreased metabolism in the region of the precuneus and in the right superior frontal gyrus (rSFG) in the diabetic group as compared to the obese patients. Data analysis corrected for pre-PET glucose level showed a hypometabolic difference only in the rSFG in T2DM. Voxel-based correlation analysis showed significant negative correlation of the metabolism in the following brain regions with pre-PET glucose in diabetes: precuneus, left posterior orbital gyrus, right calcarine cortex and right orbital part of inferior frontal gyrus; whilst in the obese group only the right rolandic (pericentral) operculum proved to be sensitive to pre-PET glucose level. Conclusions To our knowledge, this is the first study to perform pre-PET glucose level corrected comparative analysis of brain metabolism in T2DM and obesity. We also examined the pre-PET glucose level dependency of regional cerebral metabolism in the two groups separately. Large-scale future studies are warranted to perform further correlation analysis with the aim of determining the effects of metabolic disturbances on brain metabolism.

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Section: Discussionsupporting

confidence: 91%

Glucose-level dependent brain hypometabolism in type 2 diabetes mellitus and obesity

Képes

Aranyi

Forgács³

et al. 2021

European J Hybrid Imaging

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show abstract

“…In our research, voxel-bases group comparison revealed hypometabolism in the region of the precuneus in the diabetic group compared to the obese. This could be in line with the results of Apostolova and coauthors who pointed out that elevated blood glucose level (98.4 ± 15.8 mg/dl/5,5 ± 0,88 mmol/L), even in the normal range (reference range 59-149 mg/dl/3,3-8,34 mmol/L) is associated with a decrease regarding [ 18 F]FDG uptake in the posterior cortex [30]. Increasing plasma glucose levels causing reduced brain glucose metabolism in the region of the precuneus and the posterior cingulate gyrus detected by Ishibashi K and co-workers could also be in coherence with our result [31].…”

Section: Discussionsupporting

confidence: 91%

Glucose-level dependent brain hypometabolism in type 2 diabetes mellitus and obesity

Képes

Aranyi

Forgács³

et al. 2020

Preprint

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Background: Metabolic syndrome and its individual components lead to wide-ranging consequences, many of which affect the central nervous system. In this study, we compared the [18F]FDG regional brain metabolic pattern of participants with type 2 diabetes mellitus (T2DM) and non-DM obese individuals.Methods: In our prospective study 51 patients with controlled T2DM (ages 50.6 ± 8.0 years) and 45 non-DM obese participants (ages 52.0 ± 9.6 years) were enrolled. Glucose levels measured before PET/CT examination (pre-PET glucose) as well as laboratory parameters assessing glucose and lipid status were determined. NeuroQ application (NeuroQTM 3.6, Syntermed, Philips) was used to evaluate regional brain metabolic differences. [18F]FDG PET/CT (AnyScan PC, Mediso) scans, estimating brain metabolism were transformed to MNI152 brain map after T1 registration and used for SPM-based group comparison of brain metabolism corrected for pre-PET glucose, and correlation analysis with laboratory parameters. Results: NeuroQ analysis did not reveal significant regional metabolic defects in either group. Voxel-based group comparison revealed significantly (pFWE<0.05) decreased metabolism in the region of the precuneus and in the right superior frontal gyrus (rSFG) in the diabetic group as compared to the obese patients. Data analysis corrected for pre-PET glucose level showed a hypometabolic difference only in the rSFG in T2DM. Voxel-based correlation analysis showed significant negative correlation of the metabolism in the following brain regions with pre-PET glucose in diabetes: precuneus, left posterior orbital gyrus, right calcarine cortex and right orbital part of inferior frontal gyrus; while in the obese group only the right rolandic (pericentral) operculum proved to be sensitive to pre-PET glucose level.Conclusions: To our knowledge this is the first study to perform pre-PET glucose level corrected comparative analysis of brain metabolism in T2DM and obesity. We also examined the pre-PET glucose level dependency of regional cerebral metabolism in the two groups separately. Large-scale future studies are warranted to perform further correlation analysis with the aim of determining the effects of metabolic disturbances on brain metabolism.

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“…When hyperglycemia is present (>160 mg/dl; >8.9 nmol/L), there is an increased competition of elevated plasma glucose with [ 18 F]FDG on carrier enzyme and, because it is usually associated with high intracellular glucose levels, also on hexokinase enzyme. As a general rule, there is a decrease in [ 18 F]FDG influx rate constant (K 1 ) quantitatively paralleling blood glucose concentrations, resulting in deterioration of image quality with increasing glucose concentrations [ 91 , 92 ]. In the case of hyperglycemia, [ 18 F]FDG uptake is expected to be reduced in the whole brain (with stochastic noise increased).…”

Section: Methodsmentioning

confidence: 99%

EANM procedure guidelines for brain PET imaging using [18F]FDG, version 3

Guedj

Varrone

Boellaard

et al. 2021

Eur J Nucl Med Mol Imaging

113

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The present procedural guidelines summarize the current views of the EANM Neuro-Imaging Committee (NIC). The purpose of these guidelines is to assist nuclear medicine practitioners in making recommendations, performing, interpreting, and reporting results of [18F]FDG-PET imaging of the brain. The aim is to help achieve a high-quality standard of [18F]FDG brain imaging and to further increase the diagnostic impact of this technique in neurological, neurosurgical, and psychiatric practice. The present document replaces a former version of the guidelines that have been published in 2009. These new guidelines include an update in the light of advances in PET technology such as the introduction of digital PET and hybrid PET/MR systems, advances in individual PET semiquantitative analysis, and current broadening clinical indications (e.g., for encephalitis and brain lymphoma). Further insight has also become available about hyperglycemia effects in patients who undergo brain [18F]FDG-PET. Accordingly, the patient preparation procedure has been updated. Finally, most typical brain patterns of metabolic changes are summarized for neurodegenerative diseases. The present guidelines are specifically intended to present information related to the European practice. The information provided should be taken in the context of local conditions and regulations.

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Impact of plasma glucose level on the pattern of brain FDG uptake and the predictive power of FDG PET in mild cognitive impairment

Cited by 17 publications

References 17 publications

Glucose-level dependent brain hypometabolism in type 2 diabetes mellitus and obesity

Glucose-level dependent brain hypometabolism in type 2 diabetes mellitus and obesity

Glucose-level dependent brain hypometabolism in type 2 diabetes mellitus and obesity

EANM procedure guidelines for brain PET imaging using [18F]FDG, version 3

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