Quantitative Analysis of Metabolic Abnormality Associated with Brain Developmental Venous Anomalies

Dmitriy Timerman; Jasmine A Thum; Mykol Larvie

doi:10.7759/cureus.799

Quantitative Analysis of Metabolic Abnormality Associated with Brain Developmental Venous Anomalies

Cureus. 2016 Sep 21;8(9):e799. doi: 10.7759/cureus.799.

Authors

Dmitriy Timerman¹, Jasmine A Thum², Mykol Larvie³

Affiliations

¹ Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School.
² Radiology, Harvard Medical School.
³ Department of Radiology, Massachusetts General Hospital, Boston, MA ; Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School.

Abstract

Background and purpose: Abnormal hypometabolism is common in the brain parenchyma surrounding developmental venous anomalies (DVAs), although the degree of DVA-associated hypometabolism (DVAAh) has not been quantitatively analyzed. In this study, we demonstrate a simple method for the measurement of DVAAh and test the hypothesis that DVAs are associated with a quantifiable decrement in metabolic activity.

Materials and methods: Measurements of DVAAh using ratios of standardized uptake values (SUVs) and comparison to a normal database were performed on a cohort of 25 patients (12 male, 13 female), 14 to 76 years old, with a total of 28 DVAs (20 with DVAAh, seven with isometabolic activity, and one with hypermetabolic activity).

Results: Qualitative classification of none, mild, moderate, and severe DVAAh corresponded to quantitative measurements of DVAAh of 1 ± 3%, 12 ± 7%, 18 ± 6%, and 37 ± 6%, respectively. A statistically significant linear correlation between DVAAh and age was observed (P = 0.003), with a 3% reduction in metabolic activity per decade. A statistically significant linear correlation between DVAAh and DVA size was observed (P = 0.01), with a 4% reduction in metabolic activity per each 1 cm in the longest dimension. The SUV_DVA-based measures of DVAAh correlated (P = 0.001) with measures derived from comparison with a standardized database.

Conclusion: We present a simple method for the quantitative measurement of DVAAh using ratios of SUVs, and find that this quantitative analysis is consistent with a qualitative classification. We find that 54% (15 of 28) of DVAs are associated with a greater than 10% decrease in metabolic activity.

Keywords: developmental venous anomaly; dva; dva-associated hypometabolism; pet imaging.

Grants and funding

This work was partially funded by the 2014 Radiological Society of North America (RSNA) Research Medical Student Grant #RMS1429 ("Quantitative analysis of cortical thickness and metabolic activity in patients with developmental venous anomalies").