In the last years, an increasing interest in molecular imaging has been raised by
the extending potential of positron emission tomography [PET]. The role of PET imaging,
originally confined to the oncology setting, is continuously extending thanks to the development
of novel radiopharmaceutical and to the implementation of hybrid imaging techniques,
where PET scans are combined with computed tomography [CT] or magnetic
resonance imaging[MRI] in order to improve spatial resolution.
Early preclinical studies suggested that 18F–FDG PET can detect neuroinflammation;
new developing radiopharmaceuticals targeting more specifically inflammation-related
molecules are moving in this direction. Neurological involvement is a distinct feature of
various systemic autoimmune diseases, i.e. Systemic Lupus Erythematosus [SLE] or
Behcet’s disease [BD]. Although MRI is largely considered the gold-standard imaging
technique for the detection of Central Nervous System [CNS] involvement in these disorders.
Several patients complain of neuropsychiatric symptoms [headache, epilepsy, anxiety
or depression] in the absence of any significant MRI finding; in such patients the diagnosis
relies mainly on clinical examination and often the role of the disease process
versus iatrogenic or reactive forms is doubtful.
The aim of this review is to explore the state-of-the-art for the role of PET imaging in
CNS involvement in systemic rheumatic diseases. In addition, we explore the potential
role of emerging radiopharmaceutical and their possible application in aiding the diagnosis
of CNS involvement in systemic autoimmune diseases.