Contribution of the 18F-FDG PET/CT IN sporadic Creutzfeldt-Jakob disease

Abstract

Sporadic Creutzfeldt-Jakob disease (ECJs) is an extremely rare transmissible neurodegenerative disorder characterized by rapidly progressive dementia. In the positron emission tomography with 18F-fluoro-2-deoxy-D-glucose (FDG-PET) of these patients, bilateral parietal, frontal and occipital cortical hypometabolism has been described, without alterations in the cerebellum or in the basal ganglia, which it could contribute to the differential diagnosis of rapidly progressive dementia. We report a case of a 75-year-old male that had past medical history of prostate cancer and bipolar affective disorder, presented with 2 weeks of behavioral and mood changes, cognitive deficit, visual and auditory hallucinations and spatial disorientation with rapid progression; later he presentedslow gait, intermittent distal tremor in the lower limbs and right Babinski. The contrast-enhanced brain magnetic resonance imaging(MRI) showed diffusion restriction in the bilateral frontal cortex, temporal cortex and cingulate gyrus, with a diagnosis of paraneoplastic syndrome versus prion disease; FDG-PET with hypometabolism in the bilateral frontal cortex and the right temporal and parietal lobe. A study of cerebrospinal fluid protein 14-3-3, T-Tau protein, and real-time quaking-induced conversion (RT-QUIC) indicating a definitive diagnosis of prion disease.