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Positron emission tomography, magnetic resonance imaging and proton NMR spectroscopy of white matter in multiple sclerosis

Department of Nuclear Medicine, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

Paul Van Hecke

Department of Radiology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

Rik Vandenberghe

Department of Neurology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

Sylvie Van Oostende

Department of Radiology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

Patrick Dupont

Department of Nuclear Medicine, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

Philippe Demaerel

Department of Radiology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

Guy Bormans

Department of Nuclear Medicine, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

Herwig Carton

Department of Neurology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

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. Conclusion: 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.

Key Words: multiple sclerosis • magnetic resonance imaging • NMR spectroscopy • positron emission tomography • white matter • FDG

Multiple Sclerosis, Vol. 3, No. 1, 8-17 (1997)
DOI: 10.1177/135245859700300102


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