title: Assessment of brain damage and plasticity in the visual system due to early occipital lesion: comparison of FDG-PET with diffusion MRI tractography.
abstract: OBJECTIVE
  To determine the relation between glucose metabolic changes of the primary visual cortex, structural abnormalities of the corresponding visual tracts, and visual symptoms in children with Sturge-Weber syndrome (SWS).
  
  
  METHODS
  In 10 children with unilateral SWS (ages 1.5-5.5 years), a region-of-interest analysis was applied in the bilateral medial occipital cortex on positron emission tomography (PET) and used to track diffusion-weighted imaging (DWI) streamlines corresponding to the central visual pathway. Normalized streamline volumes of individual SWS patients were compared with values from age-matched control groups as well as correlated with normalized glucose uptakes and visual field deficit.
  
  
  RESULTS
  Lower glucose uptake and lower corresponding streamline volumes were detected in the affected occipital lobe in 9/10 patients, as compared to the contralateral side. Seven of these 9 patients had visual field deficit and normal or decreased streamline volumes on the unaffected side. The two other children had no visual symptoms and showed high contralateral visual streamline volumes. There was a positive correlation between the normalized ratios on DWI and PET, indicating that lower glucose metabolism was associated with lower streamline volume in the affected hemisphere (R = 0.70, P = 0.024).
  
  
  CONCLUSIONS
  We demonstrated that 18F-flurodeoxyglucose (FDG)-PET combined with DWI tractography can detect both brain damage on the side of the lesion and contralateral plasticity in children with early occipital lesions.
authors.affiliation: Department of Pediatrics, School of Medicine, Wayne State University, Detroit, Michigan, USA; Department of Neurology, School of Medicine, Wayne State University, Detroit, Michigan, USA; PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan, USA.
authors.forename: Jeong-won
authors.initials: JW
authors.lastname: Jeong
authors.forename: Vijay N
authors.initials: VN
authors.lastname: Tiwari
authors.forename: Joseph
authors.initials: J
authors.lastname: Shin
authors.forename: Harry T
authors.initials: HT
authors.lastname: Chugani
authors.forename: Csaba
authors.initials: C
authors.lastname: Juhász
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D013341:Sturge-Weber Syndrome / Q000473:pathology*; D014793:Visual Cortex / Q000473:pathology*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: DWI tractography; FDG-PET; Sturge-Weber Syndrome