Radiation therapy-related ataxia associated with FDG-PET cerebellar hypometabolism

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Radiation therapy-related ataxia associated with FDG-PET cerebellar hypometabolism

2010, N° 1 (Vol. 110/1) p.100-102

Dimitri Renard(1), Laurent Collombier(2), Giovanni Castelnovo(1), Genevieve Fourcade(1), Charles Debrigode(3) and Pierre Labauge(1)

1Department of Neurology, 2Department of Nuclear Medicine, 3Department of Radiotherapy and Oncology, CHU Nîmes, Hôpital Caremeau, Nîmes Cedex 4, France

Abstract:

Brain FDG-PET after radiation therapy is classically used to differentiate between tumor recurrence and radiation-related tumor necrosis. Little is known about FDG-PET in patients with radiation-induced leukoencephalopathy without radiological aspect of necrosis. We present a 69-year-old woman who had preventive whole brain radiation after a diagnosis of paraneoplastic Lambert-Eaton syndrome related to small cell lung cancer. Five months after radiation therapy, she developed radiation-induced leukoencephalopathy manifested by ataxia. Profound cerebellar hypometabolism on FDG-PET was in contrast with the presence of only discrete cerebellar white matter changes on MRI. FDG-PET abnormalities seem to correlate better with clinical signs related to radiation-associated brain toxicity than MRI.