Neuromyelitis Optica Spectrum Disorder: 2-Deoxy-2-[¹⁸F]Fluoro-D-Glucose Positron Emission Tomography Findings

Abstract

A 51-year-old female with a history of rheumatoid arthritis rapidly developed anterior neck pain and paresis in the left upper and lower extremities and right lower extremity, sensory disturbance in the left upper and lower extremities, and bladder and rectal disorder. Adduction of the left eye and abduction of the right eye were also disturbed. Spinal magnetic resonance imaging demonstrated severe edema in the C1-T5 levels, which then deteriorated rapidly over 3 days, and lesions enhanced with gadolinium in the C1-C3 and C5-T3 levels. 2-Deoxy-2-[ 18 F]fluoro-D-glucose positron emission tomography study demonstrated the inflammatory sites as segmental enhanced accumulation in the C1-C3, C5-C6, and T1 levels. The serum anti-aquaporin 4 antibody level was positive and she was diagnosed with neuromyelitis optica spectrum disorder. Marked improvement in the neurological conditions, concomitant with reduced spinal cord edema, was obtained by steroid pulse therapy.

Spine Infections: The Role of Fluorodeoxyglucose Positron Emission Tomography (FDG PET) in the Context of the Actual Diagnosis Guideline

“…It has to be reminded that FDG is not tumour or infective specific [ 69 , 70 ], and it could help in the identification of the right site for biopsy [ 71 , 72 ]. It has to be mentioned that FDG uptake was found in inflammatory and rheumatologic diseases [ 73 , 74 ], such as aseptic spondylodiscitis in a patient with HLA-B27 positive patient [ 74 ]. We always have to remember that FDG is not specific for the presence of microorganism, but the presence of our immune system reaction to external offences and increased metabolism cells, such as tumoral ones.…”