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| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2012;5(2):201-207
Original Article
Imaging astrocytosis with PET in Creutzfeldt-Jakob disease: case report with
histopathological findings
Henry Engler, Inger Nennesmo, Eva Kumlien, Juan Pablo Gambini, PO Lundberg, Irina Savitcheva, Bengt Långström
Department of Nuclear Medicine, Uppsala University Hospital, Sweden; Department of Nuclear Medicine, University Hospital of Clinics,
Montevideo, Uruguay; Center of Nuclear Research, Faculty of Sciences, Montevideo, Uruguay; Department of Pathology, Karolinska
University Hospital, Huddinge, Stockholm; Department of Radiology, Karolinska University Hospital, Huddinge, Stockholm; Department
of Organic Chemistry, Uppsala University, Sweden; Centro Uruguayo de Imagenología Molecular, CUDIM, Uruguay
Received February 17, 2012; accepted March 29, 2012; Epub April 6, 2012; Published April 30, 2012
Abstract: In a previous study, patients with suspect Creutzfeldt-Jakob’s disease (CJD) have been examined with Positron Emission
Tomography (PET) combining N-[11C-methyl]-L-deuterodeprenyl (DED) and [18F] 2-fluorodeoxyglucose (FDG) in an attempt to detect
astrocytosis and neuronal dysfunction, two of the hallmarks in CJD. Increased DED uptake with pronounced hypometabolism matching
the areas with high DED retention was found in the fronto-parieto-occipital areas and cerebellum of patients with confirmed CJD.
However, the temporal lobes did not present such a pattern. In 6 of the 15 examined patients the autopsy was performed but a strict
comparison between the PET results and the histopathology could not be performed. Recently, one patient with suspect CJD was
examined with PET using DED and FDG. The results of the examinations in this patient showed a pattern similar to that found in the
brain of the CJD patients from the first study. The patient died shortly after the examination and an autopsy could be performed. The
autopsy showed neuronal death, astrocytosis and spongiform changes in the brain. The diagnosis of definite sporadic CJD was
established after typing of the prion resistant protein (PrPres). The PET data demonstrated high DED uptake and extreme low glucose
uptake in the left brain hemisphere whereas the right side was less affected. The autopsy was performed allowing the comparison
between high DED uptake and the histopathological findings of reactive astrocytosis revealed by immunostaining with antibodies
against glial fibrillary acid protein (GFAP). The results confirmed the presence of a pattern with high ratio DED/FDG, similar to that found
in the previous study and revealing good correlation between high DED uptake and high density of reactive astrocytes as demonstrated
by immunostaining. (IJCEM1202007).
Keywords: Astrocytosis, PET, CJD, histopathology
Address all correspondence to:
Dr. Henry Engler
Uruguayan Centre of Molecular Imaging (CUDIM)
Montevideo, Uruguay.
Department of Nuclear Medicine
University Hospital of Clinics, Montevideo
Uruguay, Center of Nuclear Research
Faculty of Sciences
Montevideo, Uruguay.
Department of Nuclear Medicine
Uppsala University Hospital
Sweden.
E-mail: Henry.Engler@cudim.org
Original Article
Imaging astrocytosis with PET in Creutzfeldt-Jakob disease: case report with
histopathological findings
Henry Engler, Inger Nennesmo, Eva Kumlien, Juan Pablo Gambini, PO Lundberg, Irina Savitcheva, Bengt Långström
Department of Nuclear Medicine, Uppsala University Hospital, Sweden; Department of Nuclear Medicine, University Hospital of Clinics,
Montevideo, Uruguay; Center of Nuclear Research, Faculty of Sciences, Montevideo, Uruguay; Department of Pathology, Karolinska
University Hospital, Huddinge, Stockholm; Department of Radiology, Karolinska University Hospital, Huddinge, Stockholm; Department
of Organic Chemistry, Uppsala University, Sweden; Centro Uruguayo de Imagenología Molecular, CUDIM, Uruguay
Received February 17, 2012; accepted March 29, 2012; Epub April 6, 2012; Published April 30, 2012
Abstract: In a previous study, patients with suspect Creutzfeldt-Jakob’s disease (CJD) have been examined with Positron Emission
Tomography (PET) combining N-[11C-methyl]-L-deuterodeprenyl (DED) and [18F] 2-fluorodeoxyglucose (FDG) in an attempt to detect
astrocytosis and neuronal dysfunction, two of the hallmarks in CJD. Increased DED uptake with pronounced hypometabolism matching
the areas with high DED retention was found in the fronto-parieto-occipital areas and cerebellum of patients with confirmed CJD.
However, the temporal lobes did not present such a pattern. In 6 of the 15 examined patients the autopsy was performed but a strict
comparison between the PET results and the histopathology could not be performed. Recently, one patient with suspect CJD was
examined with PET using DED and FDG. The results of the examinations in this patient showed a pattern similar to that found in the
brain of the CJD patients from the first study. The patient died shortly after the examination and an autopsy could be performed. The
autopsy showed neuronal death, astrocytosis and spongiform changes in the brain. The diagnosis of definite sporadic CJD was
established after typing of the prion resistant protein (PrPres). The PET data demonstrated high DED uptake and extreme low glucose
uptake in the left brain hemisphere whereas the right side was less affected. The autopsy was performed allowing the comparison
between high DED uptake and the histopathological findings of reactive astrocytosis revealed by immunostaining with antibodies
against glial fibrillary acid protein (GFAP). The results confirmed the presence of a pattern with high ratio DED/FDG, similar to that found
in the previous study and revealing good correlation between high DED uptake and high density of reactive astrocytes as demonstrated
by immunostaining. (IJCEM1202007).
Keywords: Astrocytosis, PET, CJD, histopathology
Address all correspondence to:
Dr. Henry Engler
Uruguayan Centre of Molecular Imaging (CUDIM)
Montevideo, Uruguay.
Department of Nuclear Medicine
University Hospital of Clinics, Montevideo
Uruguay, Center of Nuclear Research
Faculty of Sciences
Montevideo, Uruguay.
Department of Nuclear Medicine
Uppsala University Hospital
Sweden.
E-mail: Henry.Engler@cudim.org
