RT Journal Article
SR Electronic
T1 <strong>Global and Regional Brain Hypometabolism on FDG PET/CT Imaging Seen in Optimally Treated HIV Positive Subjects</strong>
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 485
OP 485
VO 58
IS supplement 1
A1 Wong, Jasmine
A1 Smith, Bryan
A1 Lee, Dianne
A1 Sinharay, Sanhita
A1 Steinbach, Sally
A1 Dey, Amit
A1 Mehta, Nehal
A1 Snow, Joseph
A1 Nath, Avindra
A1 Hammoud, Dima
YR 2017
UL http://jnm.snmjournals.org/content/58/supplement_1/485.abstract
AB 485Objectives: Despite improved life expectancy in HIV seropositive (HIV+) individuals, HIV-associated neurological disorders (HAND) remain a major problem. In the pre-antiretroviral therapy (ART) era, brain metabolism abnormalities in HIV were evident on FDG PET but not as much in the post-ART era. We used FDG-PET imaging to evaluate optimally-treated, virologically-suppressed HIV+ individuals, compared to age-matched healthy controls (HCs). We also correlated FDG uptake values to duration of infection, nadir CD4 values and to diagnosis of HAND.Methods: 47 HIV+ individuals and 19 age-matched HCs underwent FDG-PET/CT scanning. Whole brain total glycolytic activity (WB-TGA=SUVmean/Volume) was measured for all subjects using MIM6.6 software. In addition, regional uptake values (SUVmean and SUVmax) were evaluated using PMOD in the caudate, putamen, thalamus, cerebellum, anterior and posterior cingulate gyri.Results: Ten HIV+ subjects met criteria for HAND. WB-TGA and WB-SUVmax values were significantly lower in HIV+ subjects compared to HCs (p=0.025 and 0.021, unpaired t-test). This significance was maintained after excluding subjects with HAND (p=0.017 and 0.019). When regional SUV values were compared, thalamic and cerebellar SUVmean values were significantly lower in HIV+ subjects compared to HCs (p=0.001 and 0.007, multiple t-tests, Holm-Sidak correction, alpha=5%). Other regions (caudate, posterior and anterior cingulate cortex) had lower SUVmean values in the HIV+ population, however the differences did not survive correction for multiple comparisons. There was no significant difference in whole brain TGA values between HAND and no-HAND subjects. TGA values did not significantly correlate with duration of infection or nadir CD4.Conclusion: We found significantly lower whole brain TGA values in optimally-treated HIV+ patients compared to HCs, suggesting a pre-existing and possibly progressive pattern of brain injury despite virological control in the periphery. The use of whole brain TGA provides an accurate representation of global brain metabolism while taking into account differences in volume. Marked HIV-related thalamic hypometabolism was also seen, possibly explaining memory, executive functioning and attention deficits in this patient population. Further evaluation of socioeconomically-matched patients in comparison to HIV+ subjects will help better determine the role of HIV infection versus various other comorbidities in observed brain hypometabolism. Research Support: Intramural NIH support: Center for Infectious Disease Imaging, Radiology and Imaging Sciences, NIH/Clinical Center