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LetterLetters to the Editor

Brain 18F-FDG PET Metabolic Abnormalities in Macrophagic Myofasciitis: Are They Stable?

Paul Blanc-Durand, Axel Van Der Gucht, Mehdi Aoun Sebaiti, Mukedaisi Abulizi, François-Jérôme Authier and Emmanuel Itti
Journal of Nuclear Medicine September 2017, 58 (9) 1532-1533; DOI: https://doi.org/10.2967/jnumed.117.190876
Paul Blanc-Durand
*Hôpital Henri Mondor AP-HP 51 Ave. du Mal de Lattre de Tassigny F-94010 Créteil, France E-mail:
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  • For correspondence: paul.blancdurand@gmail.com
Axel Van Der Gucht
*Hôpital Henri Mondor AP-HP 51 Ave. du Mal de Lattre de Tassigny F-94010 Créteil, France E-mail:
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  • For correspondence: paul.blancdurand@gmail.com
Mehdi Aoun Sebaiti
*Hôpital Henri Mondor AP-HP 51 Ave. du Mal de Lattre de Tassigny F-94010 Créteil, France E-mail:
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Mukedaisi Abulizi
*Hôpital Henri Mondor AP-HP 51 Ave. du Mal de Lattre de Tassigny F-94010 Créteil, France E-mail:
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François-Jérôme Authier
*Hôpital Henri Mondor AP-HP 51 Ave. du Mal de Lattre de Tassigny F-94010 Créteil, France E-mail:
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Emmanuel Itti
*Hôpital Henri Mondor AP-HP 51 Ave. du Mal de Lattre de Tassigny F-94010 Créteil, France E-mail:
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TO THE EDITOR: We are writing this letter as an addition to our recently published study (1). Our aim is to add some insight to the evolution of the brain abnormalities that are observed with macrophagic myofasciitis (MMF). MMF is a chronic disease whose evolution is slow and whose symptoms may first occur months to years after a vaccination containing aluminum hydroxide adjuvant particles (2). Nevertheless, the evolution of MMF is not fully understood or known. MMF-associated cognitive dysfunction is based on a tripod combining dysexecutive syndrome, memory impairment, and interhemispheric disconnection. One pilot study suggested that MMF-associated cognitive dysfunction appears to be clinically stable over time (3), and a recent study evaluating a support vector machine classifier suggested that the abnormalities observed with 18F-FDG PET may be sensitive and can be used to monitor patients.

In order to evaluate the evolution of 18F-FDG PET brain metabolic abnormalities, we retrospectively included 18 patients on whom an additional follow-up 18F-FDG PET brain scan was performed because of persisting cognitive complaints (median age, 56.9 y [range, 22.3–66.2 y]). 18F-FDG PET was performed following the same brain protocol acquisition as previously described (1). The Institutional Review Board (Comité de Protection des Personnes Ile-de-France VI), taking into account the retrospective nature of the study, approved the protocol (December 18, 2013) without requiring informed consent by the patients. The median time between the two examinations was 32.9 mo (range, 6.4–48.6 mo). Using analysis of covariance and negative or positive contrast in SPM12, we generated a t test mask by comparing the mean of the first cerebral 18F-FDG PET acquisition with that of the second. The results of the comparison were collected at a P value of less than 0.005 at the voxel level, for clusters of at least 200 voxels (corrected for cluster volume).

Brain abnormality maps did not show any statistically significant negative or positive metabolic difference between the two examinations, confirming the idea that MMF is a slowly progressive or nonprogressive disease, in concordance with the fact that neurologic symptoms—even if they fluctuate—do not worsen or improve over time.

Footnotes

  • Published online Mar. 16, 2017.

  • © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

REFERENCES

  1. 1.↵
    1. Van Der Gucht A,
    2. Aoun Sebaiti M,
    3. Guedj E,
    4. et al
    . Brain 18F-FDG PET metabolic abnormalities in patients with long-lasting macrophagic myofasciitis. J Nucl Med. 2017;58:492–498.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Gherardi RK,
    2. Coquet M,
    3. Chérin P,
    4. et al
    . Macrophagic myofasciitis: an emerging entity. Groupe d’Etudes et Recherche sur les Maladies Musculaires Acquises et Dysimmunitaires (GERMMAD) de l’Association Française contre les Myopathies (AFM). Lancet. 1998;352:347–352.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Passeri E,
    2. Villa C,
    3. Couette M,
    4. et al
    . Long-term follow-up of cognitive dysfunction in patients with aluminum hydroxide-induced macrophagic myofasciitis (MMF). J Inorg Biochem. 2011;105:1457–1463.
    OpenUrlCrossRefPubMed
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Journal of Nuclear Medicine: 58 (9)
Journal of Nuclear Medicine
Vol. 58, Issue 9
September 1, 2017
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Brain 18F-FDG PET Metabolic Abnormalities in Macrophagic Myofasciitis: Are They Stable?
Paul Blanc-Durand, Axel Van Der Gucht, Mehdi Aoun Sebaiti, Mukedaisi Abulizi, François-Jérôme Authier, Emmanuel Itti
Journal of Nuclear Medicine Sep 2017, 58 (9) 1532-1533; DOI: 10.2967/jnumed.117.190876

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Brain 18F-FDG PET Metabolic Abnormalities in Macrophagic Myofasciitis: Are They Stable?
Paul Blanc-Durand, Axel Van Der Gucht, Mehdi Aoun Sebaiti, Mukedaisi Abulizi, François-Jérôme Authier, Emmanuel Itti
Journal of Nuclear Medicine Sep 2017, 58 (9) 1532-1533; DOI: 10.2967/jnumed.117.190876
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