Positron emission tomography, magnetic resonance imaging and proton NMR spectroscopy of white matter in multiple sclerosis.
OBJECTIVE
To assess characteristics of MS lesions and normal appearing white matter (NAWM) with various imaging modalities. Glucose metabolism was investigated with FDG-PET, metabolite concentration with proton NMR spectroscopy, and lesion detection with routine brain MRI.


METHODS
Thirteen patients were studied in a stable phase of their disease, and two during an acute episode. Nine healthy volunteers served as controls.


RESULTS
Three patients had a normal brain MRI, 12 had typical lesions. MR images were registered to the PET planes. Lesions and contra-lateral control areas were analyzed, 10/15 lesions showed relative hyper-metabolism and 2 hypo-metabolism. NAA concentration was significantly decreased in both lesions and NAWM.


CONCLUSIONS
In stable MS, most large lesions have a relatively increased glucose utilization and decreased NAA concentration. NAWM showed a significantly decreased NAA concentration compared to healthy subjects, but no difference in glucose metabolism. Active lesions in acute MS are also hyper-metabolic. This finding opens a new window on the classification of white matter lesions based on glucose utilization.
Schiepers
C
C
Department of Nuclear Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
Van Hecke
P
P
Vandenberghe
R
R
Van Oostende
S
S
Dupont
P
P
Demaerel
P
P
Bormans
G
G
Carton
H
H
D000208:Acute Disease; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D003847:Deoxyglucose / Q000031:analogs & derivatives; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D009994:Osmolar Concentration; D010487:Periaqueductal Gray / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012016:Reference Values; D014055:Tomography, Emission-Computed
D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D005947:Glucose