Brain positron emission tomography in preterm and term newborn infants☆
Introduction
Positron emission tomography PET is a noninvasive measurement of the levels of radiopharmaceuticals labeled with positron emitters. The most frequently used tracer for the assessment of tissue glucose metabolism is 18F-fluorodeoxyglucose (18F-FDG) [1]. PET has been widely used in a lot of cerebral diseases in adults. Only a few pediatric and even fewer neonatal PET studies have been presented so far. Preliminary research has suggested that PET scan might have some changes in term newborn infants with hypoxic ischemic encephalopathy [2], [3], [4]. There have been few data on PET scan in preterm infants except one research report, which studied the cerebral glucose transport and metabolism in 6 preterm infants. In addition, all the previous studies were performed in ill neonates [5]. Up to now, no report on PET scan in clinically normal newborn infants has been present, but some newborn infants, especially those preterm, suffered from some cerebral dysfunctions without any early clinical and experimental evidence [6]. Hence, it's reasonable that measurement of the cerebral metabolism by PET should be important to understand the physiology and pathophysiology of the developing brain in preterm and term infants.
Section snippets
Subjects
Sixteen neonates born on January 2004–December 2006 (male 9, female 7) were studied. According to their gestational age, there were 9 term and 7 preterm infants. The gestational age and the birth-weight were 33.5 ± 3.1 wk and 1650 ± 720 g in the preterm infants respectively, whereas 38.7 ± 1.6 wk and 2960 ± 1040 g in the term infants respectively. PET scan was applied at an average time of 8.4 ± 4.9 d after birth (from 3 to 21 d). All the neonates had no perinatal asphyxia with an Apgar score of 8–10.
Results
Table 1 showed the SUV values of the preterm and term newborn infants.
18F-FDG PET images were relatively high in thalamus, cerebellum, sensorimotor cortex and basal ganglia, whereas relatively low in cerebral cortex (frontal, parietal, and occipital regions). There were significant differences in SUV values in thalamus, cerebellum, basal ganglia, and parietal region of the cortical areas between preterm and term neonates. The brain 18F-FDG PET image of neonates was not clearly demarcated in
Discussion
PET offers a unique possibility and further insight into the various processes in the developing brain [10]. SUV provides a semiquantitative method to analyze PET data. A good relationship between the cerebral SUV and local cerebral metabolic rate of glucose in infants has been established [2], [11]. The SUV method has been shown to be affected by the blood glucose level in the analysis of 18F-FDG PET images. Nevertheless, if no blood samples are available in preterm and term infants, the
Acknowledgement
This study was supported by grants from the Natural Research Foundation of Chongqing, China (2004BB5249).
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2014, NeuroImage: ClinicalCitation Excerpt :A main limitation of this study is the lack of gold standard of perfusion measurements in newborns compared to adults, making it difficult to assess accuracy. However, our measurements were in accordance with brain perfusion measurements obtained in newborns by other methods, i.e., positron emission tomography (Altman et al., 1988; Shi et al., 2009) and xenon 133 clearance (Pryds et al., 1990). Another limitation of the study is that the commercially available PASL sequence that was used in this study did not employ QUIPSS2/Q2TIPS type saturation to spoil residual label in the tagging slab.
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2012, Pediatric NeurologyCitation Excerpt :In infants manifesting severe periventricular leukomalacia and hypsarrhythmia, 18F-fluorodeoxyglucose positron emission tomography could identify dysfunctions of the sensorimotor cortex, whereas magnetic resonance imaging reveals periventricular injury [22]. Our preliminary study reported the characteristics of preterm and term infants [23]. An abnormal change in cerebral glucose metabolism and local blood supply was evident in two newborn infants with a cerebral infarction [24].
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The corresponding authors have the right to grant, on behalf of all authors, an exclusive licence on a worldwide basis to permit this article (if accepted) to be published in Early Human Development. There is no competing interests.