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Regional Cerebral Blood Flow and Glucose Metabolism in Sjögren's Syndrome

Departments of Nuclear Medicine and Internal Medicine, Taichung Veterans General Hospital, Taichung; Department of Radiology, Jen-AI Hospital, Taichung; Department of Nuclear Medicine, Chung-Shan Medical College Hospital, Taichung; Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of Chian

Correspondence: For correspondence or reprints contact: Chia-Hung Kao, MD, Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Taichung Harbor Road, Section 3, Taichung 40705, Republic of China.

ABSTRACT

Involvement of the brain is one of the most important complications of Sjögren's syndrome (SS). However, diagnosis of brain involvement in SS patients is difficult due to the lack of effective imaging methods. In this study, we compared two updated brain imaging modalities, ¹⁸F-2-fluoro-2-deoxy-D-glucose (FDG) PET and ^99mTc-hexamethyl propyleneamine oxime (HMPAO) SPECT, in SS patients with neuropsychiatrie manifestations, to detect glucose metabolism of the brain and regional cerebral blood flow. Methods: Sixteen primary female SS patients with normal brain MRI findings were enrolled in this study. Results: Technetium-99m-HMPAO SPECT findings were abnormal in 13 (81%) patients. Parietal and temporal lobes were the most common areas of brain involvement. Fluorine-18-FDG PET findings were abnormal in 3 (19%) patients. Temporal lobes were the most common areas of brain involvement. Conclusion: We conclude that brain HMPAO SPECT has better correlation with clinical manifestations than brain FDG PET or CT/MRI.

Key Words: Sjögren's syndrome • fluorine-18-2-fluoro-2-deoxy-D-glucose • PET • technetium-99m-hexamethyl propyleneamine oxime • SPECT