Clinical research on using ¹⁸F-FDG PET/CT brain imaging in the diagnosis of and therapeutic effect evaluation in neonatal hypoxic-ischemic encephalopathy

Objective: Cerebral glucose metabolism was measured using ¹⁸F-FDG PET/CT in healthy full-term neonates and infants exhibiting neonatal hypoxic-ischemic encephalopathy(HIE) to investigate the role of ¹⁸F-FDG PET/CT brain imaging in HIE diagnosis and in therapeutic effect evaluation in HIE. Methods: Ten healthy full-term neonates and thirty-four term infants exhibiting different degrees of HIE (mild, n = 16; moderate, n = 11; and severe, n = 7) were included in this research. The SUV_max were measured to determine the cerebral glucose metabolism in various brain anatomical regions, including bilateral sensorimotor cortex, frontal lobe, temporal lobe, occipital lobe, thalamus, basal ganglia, brain stem, and cerebellum. The cerebral glucose metabolism in healthy neonates and infants exhibiting different degrees of HIE was compared. The glucose metabolism pre- and post-treatment was also assessed using ¹⁸F-FDG PET/CT and then compared with each other. Results: Results indicated that uptake in the major brain areas was significantly higher in healthy term newborns than in the neonatal HIE patients. Moreover, patients with severer HIE demonstrated lower cerebral glucose metabolism. Cerebral glucose metabolism in patients exhibiting different degrees of HIE was also significantly higher after treatment than before treatment. Conclusions: ¹⁸F-FDG PET/CT brain imaging demonstrated a preferable clinical applicable value in the diagnosis and therapeutic effect evaluation of HIE patients and provides a new method for treatment of neonatal brain injury. The clinical value and neonatal radiation safety of this technique warrants further investigation. (authors)