PET Scans Show Promise in Identifying Hidden Inflammation for Those With Multiple Sclerosis


The results also showed that the PET scans could show damage to the individual’s brains, which was correlated with disability and fatigue.

Positron emission tomography (PET) brain scans might be able to detect hidden inflammation for individuals with multiple sclerosis (MS), according to results of a study published in Clinical Nuclear Medicine. The study was conducted by Brigham and Women’s Hospital, a member of the Mass General Brigham health care system.1,2

Doctor examining MRI images of patient with multiple sclerosis at table in clinic, closeup | Image Credit: New Africa -

Image Credit: New Africa -

“One of the perplexing challenges for clinicians treating patients with MS is after a certain amount of time, patients continue to get worse while their MRIs don’t change,” Tarun Singhal, MD, MBBS, an associate professor of Neurology in the Brigham’s Department of Neurology, said in a press release. “This is a new approach that is potentially going to be very helpful for the field, for research, and hopefully for clinical use.”1

Investigators of the study aimed to develop individuals mapping of microglial activation (MA) with 18F-PBR06-PET, a PET scan that can detect abnormal MA in MS, according to the study authors. They wanted to determine any disease-modifying treatment efficacy to reduce MA and the clinical, radiological, and serological affects in individuals with MS.2

There were 22 individuals included with MS, with a mean age of 46 years and 16 female, according to the study authors. Eight healthy patients were included for the control group. Investigators performed 30 18F-PBR06-PET scans, where the glial activity loads on PET scores were compared for the MS and the control groups. Further, the investigators compared high efficacy disease-modifying treatment and those who were either not receiving or had lower-efficacy treatment.2

The results showed that cortical gray matter and white matter scores were high for those who had MS compared to those who did not. Furthermore, for those in the high efficacy group, both scores were significantly lower than the lower efficacy group. However, the scores were still abnormally higher than the healthy group, according to the study authors. For the higher efficacy patients, the scores were also positively correlated with physical disability, fatigue, and serum glial fibrillary acid protein levels, but were inversely correlated with cortical thickness, the study investigators said.2

The results also showed that the PET scans could show the damage to the individual’s brains, which were correlated with the disability and fatigue, according to the press release. It was also able to help the investigators to better classify patients who had high-efficacy and low-efficacy treatments.1

Key Takeaways

  1. PET scans detected higher levels of microglial activation in MS patients compared to healthy controls.
  2. Patients receiving high-efficacy treatments showed lower levels of inflammation compared to those on lower-efficacy treatments.
  3. PET scan results correlated with measures of disability, fatigue, and brain damage.

“Our therapies are excellent in that we’ve definitely improved MS patients’ lives. There’s no doubt about that, but we’re still not at the finish line,” Rohit Bakshi, MD, of the Department of Neurology, said in the press release. “This study tells us something new about the disease and may be giving us an important clue as to what is driving disease progression in patients.”1

The investigators concluded that 18F-PBR06-PET was clinically feasible and could serve as a way to evaluate inflammation for those with MS. However, the study authors noted that the sample size was small, so further investigations are needed to verify the study’s findings. They also said that there needs to be refinement of the imaging processing, according to the study authors.2

  1. PET Scans Reveal ‘Smoldering’ Inflammation in Patients with Multiple Sclerosis. News release. April 23, 2024. Accessed May 8, 2024.
  2. Singhal T, Cicero S, Rissanen E, et al. Glial Activity Load on PET Reveals Persistent "Smoldering" Inflammation in MS Despite Disease-Modifying Treatment: 18 F-PBR06 Study. Clin Nucl Med. 2024;49(6):491-499. doi:10.1097/RLU.0000000000005201
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