Chronic Alteration in Cerebral FDG Metabolism After MRI-guided HIFU for Essential Tremor: A Clinical Case With PET and MRI Correlation.

Nguyen, Nghi C; Asturias, Alexander; Feltrin, Fabricio Stewan; Oz, Orhan K; Shah, Bhavya R · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 74-year-old man with a history of monoclonal gammopathy of undetermined significance (MGUS) underwent surveillance whole-body 18 F-FDG PET 2 weeks before MRI-guided high-intensity focused ultrasound (MRgHIFU) of the left dentato-rubro-thalamic tract (DRTT) for his right-hand dominant, debilitating essential tremor. This baseline FDG PET showed normal thalamic metabolism. At 12 months post-treatment, FDG PET scan revealed a small focus of left thalamic hypometabolism, which corresponded to the left DRTT ablation area seen on post-treatment MRI. The patient was tremor-free in his right hand at 1-year follow-up. This case documents the chronic effects of MRgHIFU on cerebral FDG metabolism.

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