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| Year : 2015 | Volume
: 30
| Issue : 2 | Page : 185-186 |
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F-18 fluoro-d-glucose positron emission tomography/computed tomography in a patient with corticobasal degeneration
Alejandro Marti
National Cancer Institute; IDIME, Medical Diagnosis Institute, Bogota, Colombia
| Date of Web Publication | 11-Mar-2015 |
Correspondence Address:
Dr. Alejandro Marti
Calle 106A# 13A-40 Bogota
Colombia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0972-3919.152991
 Abstract | | |
Corticobasal degeneration is a rare neurodegenerative disorder that often eludes clinical diagnosis. The present case shows the F-18 fluoro-d-glucose positron emission tomography/computed tomography (PET/CT) of a 62-year-old man with a progressive movement disorder with asymmetric features. PET/CT examination showed a markedly right-brain hemispheric hypometabolism also involving basal ganglia. Keywords: Corticobasal degeneration, fluoro-d-glucose, parkinsonian syndromes, positron emission tomography
How to cite this article:
Marti A. F-18 fluoro-d-glucose positron emission tomography/computed tomography in a patient with corticobasal degeneration. Indian J Nucl Med 2015;30:185-6 |
How to cite this URL:
Marti A. F-18 fluoro-d-glucose positron emission tomography/computed tomography in a patient with corticobasal degeneration. Indian J Nucl Med [serial online] 2015 [cited 2022 Jan 26];30:185-6. Available from: https://www.ijnm.in/text.asp?2015/30/2/185/152991 |
A 62-year-old man complaining of dystonia, akinesia and rigidity, ideomotor apraxia, alien limb phenomena with left-sided predominance, also impairments of speech, language and gait difficulty with little response to levodopa-carbidopa. He was referred for F-18 fluoro-d-glucose (FDG) positron emission tomography (PET) with a diagnosis of parkinsonian syndrome. The examination showed a markedly right-brain hemispheric hypometabolism also involving basal ganglia [Figure 1]. These types of abnormalities have been described and tend to be dominant in the contra-lateral hemisphere to the most affected body side in corticobasal degeneration. [1] The left-brain metabolism is also abnormal although a little less dramatic than right. Right basal ganglia and thalamus showed hypometabolism [Figure 2]. This is also a known feature of advanced corticobasal degeneration. [1] This disorder is thought to be caused by the deposition of abnormally phosphorylated tau protein in cortex and basal ganglia. [2] The characteristic pattern of hypometabolism in corticobasal degeneration is contra-lateral posterior frontal/anterior parietal hypometabolism, which involves the basal ganglia also. Depending on the extent of tau deposition this can be hemispheric as in this case. FDG PET is a powerful imaging tool for differentiating idiopathic Parkinson's disease from Parkinson plus syndromes. [2],[3],[4],[5] Severe hypometabolism in the left cerebellar hemisphere compared to the right (crossed cerebellar diaschisis) was also noticed [Figure 3]. This phenomenon is thought to be caused by interruption of cortico-ponto-cerebellar tract with secondary deafferentation and a transneural metabolic depression of the contra-lateral cerebellar hemisphere. [6] Differential diagnosis includes other Parkinson plus syndromes namely: Multiple system atrophy, progressive supranuclear palsy [7],[8] and Creutzfeldt-Jakob disease More Details. [9] | Figure 2: Right basal ganglia and thalamus showing severe hypoglycolisis
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 | Figure 3: Transaxial and coronal images showing severe hypometabolism in the left cerebellar hemisphere compared to the right (crossed cerebellar diaschisis)
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| References | |  |
| 1. | Eckert T, Barnes A, Dhawan V, Frucht S, Gordon MF, Feigin AS, et al. FDG PET in the differential diagnosis of parkinsonian disorders. Neuroimage 2005;26:912-21.  |
| 2. | Tolosa E, Calandrella D, Gallardo M. Caribbean parkinsonism and other atypical parkinsonian disorders. Parkinsonism Relat Disord 2004;10 Suppl 1:S19-26. |
| 3. | Akdemir ÜÖ, Tokçaer AB, Karakuş A, Kapucu LÖ. Brain 18F-FDG PET imaging in the differential diagnosis of parkinsonism. Clin Nucl Med 2014;39:e220-6. |
| 4. | Hosaka K, Ishii K, Sakamoto S, Mori T, Sasaki M, Hirono N, et al. Voxel-based comparison of regional cerebral glucose metabolism between PSP and corticobasal degeneration. J Neurol Sci 2002;199:67-71. |
| 5. | Juh R, Kim J, Moon D, Choe B, Suh T. Different metabolic patterns analysis of parkinsonism on the 18F-FDG PET. Eur J Radiol 2004;51:223-33. |
| 6. | Agrawal KL, Mittal BR, Bhattacharya A, Khandelwal N, Prabhakar S. Crossed cerebellar diaschisis on F-18 FDG PET/CT. Indian J Nucl Med 2011;26:102-3. [ PUBMED]  |
| 7. | Kwon KY, Choi CG, Kim JS, Lee MC, Chung SJ. Comparison of brain MRI and 18F-FDG PET in the differential diagnosis of multiple system atrophy from Parkinson's disease. Mov Disord 2007;22:2352-8. |
| 8. | Mahapatra RK, Edwards MJ, Schott JM, Bhatia KP. Corticobasal degeneration. Lancet Neurol 2004;3:736-43. |
| 9. | Zhang Y, Minoshima S, Vesselle H, Lewis DH. A case of Creutzfeldt-Jakob disease mimicking corticobasal degeneration: FDG PET, SPECT, and MRI findings. Clin Nucl Med 2012;37:e173-5. |
[Figure 1], [Figure 2], [Figure 3]
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