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ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1457758
This article is part of the Research Topic Neurological Autoimmunity: etiology, infectious complications, treatment strategies and outcomes in antibody-associated syndromes and beyond View all 21 articles
Towards an optimal diagnostic and prognostic model based on semi-quantitative assessment of 18 F-FDG PET in children with autoimmune encephalitis
Provisionally accepted
Ziyuan Li 1
Jing Wu 2 Shuqi Wu 1
Shenrui Guo 1 Mingming Cao 1
Weiwei Cheng 1
Hui Wang 1
Ling Li 2
Yafu Yin 1*- 1 Department of Nuclear Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- 2 Department of Pediatric Neurology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai, China
The metabolic pattern in autoimmune encephalitis (AE) has been frequently reported.Through this semi-quantitative analysis, we aim to explore a practical diagnostic model based on positron emission tomography (PET) for timely diagnosis of pediatric AE with high accuracy.Moreover, we aim to identify factors that affect the prognosis of pediatric AE and explore the utility of PET as a prognostic biomarker.Method: Data were collected from 93 AE patients and 67 non-AE patients (age range: 1-18 years old). Semi-quantitative parameters of 18 F-FDG PET imaging were evaluated, including the score of cortical lesion extent and the ratios of lesion-to-basal ganglia and thalamus. The Clinical Assessment Scale in Autoimmune Encephalitis (CASE) was used to rate the disease severity and long-term outcome. Multivariate statistical analysis was used to establish a diagnostic model and analyze predictors.The diagnostic model includes three PET parameters.The sensitivity, specificity, and accuracy of the model are 91.4%, 85.1%, and 88.8%, respectively.Participants were followed up for a median of 34 months.Logistic regression analysis indicated that male, initial CASE score >4.5,memory dysfunction, and the ratio of the maximum SUV of the lesion to thalamus (SUVRmax L/T ) < 0.577 are independent factors associated with poor prognosis in AE. We established a prognostic model through these predictors.18 F-FDG PET plays a vital role in the diagnosis and prognosis of AE. The PET-based diagnostic model has higher specificity and accuracy than visual analysis. The prognostic model is a useful predictive tool for the long-term prognosis of children with AE.
Keywords: autoimmune encephalitis, Children, positron emission tomography, semi-quantitative, prognosis
Received: 01 Jul 2024; Accepted: 26 Feb 2025.
Copyright: © 2025 Li, Wu, Wu, Guo, Cao, Cheng, Wang, Li and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yafu Yin, Department of Nuclear Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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