Hybrid 18F-florbetapir PET/MRI for assessing myelin recovery in GFAP-A patients

• Published in: Translational neuroscience Vol. 13; no. 1; pp. 120 - 124
• Main Authors: Meng, Huanyu, Zheng, Shuyu, Yuan, Shaicun, Zhou, Qinming, Gao, Yining, Ni, You, He, Lu, Yin, Dou, Zhang, Min, Chen, Sheng
• Format: Journal Article
• Language: English
• Published: Warsaw De Gruyter 09.06.2022; De Gruyter Poland
• Subjects: 18f-florbetapir pet/mri; Autoimmune diseases; autoimmune encephalitis; Brain damage; Case reports; Central nervous system; Demyelination; Emission analysis; F-florbetapir PET/MRI; Fluorine isotopes; Glial fibrillary acidic protein; Lesions; Magnetic resonance imaging; Medical imaging; Myelin; myelin recovery; Nervous system; Neuroimaging; neuroinflammation; Patients; Positron emission; Positron emission tomography; Recovery; Substantia alba; Tomography
• ISSN: 2081-3856; 2081-6936
• DOI: 10.1515/tnsci-2022-0223

Glial fibrillary acidic protein astrocytopathy (GFAP-A) is a rare autoimmune disease of the central nervous system that was newly reported in 2016. Previous studies have speculated that the pathological mechanism and clinical outcome of GFAP-A lie in the demyelination of the central nervous system, but due to the limitations of MR, this conclusion has not been further confirmed from the perspective of neuroimaging. A non-invasive, quantitative measurement of demyelination would be clinically valuable, given its critical role in mediating GFAP-A. Here, we report a case in which we use F-florbetapir positron emission tomography-magnetic resonance imaging (PET/MRI) to evaluate myelin recovery with follow-up in the patient with GFAP-A. Our patient displayed a decreased uptake of PET tracer F-florbetapir in the brain lesions and lower distribution volume ratio in the damaged white matter lesions compared to the normal-appearing white matter, indicating significant intracranial demyelination. After treatment, the F-florbetapir PET/MRI examination showed a significant increase in the uptake of F-florbetapir in the brain lesions, along with a reduced Expanded Disability Status Scale score. Although only a small number of patients have been validated, this case first reported F-florbetapir PET/MRI could quantitatively and non-invasively assess the myelin recovery in GFAP-A patients, which may lead to improvements in the early diagnosis and long-term prognosis.