Interesting ImagesTSPO PET With 18F-GE-180 to Differentiate Variants of Multiple Sclerosis Relapsing-Remitting Multiple Sclerosis, Tumefactive Demyelination, and Baló’s Concentric SclerosisVölk, Stefanie MD∗; Unterrainer, Marcus MD, MSc†,‡; Albert, Nathalie L. MD†,§; Havla, Joachim MD∥; Gerdes, Lisa Ann MD∥; Schumacher, Minh MD∥; Brendel, Matthias MD†; Kaiser, Lena PhD†; Adorjan, Kristina MD¶; Rupprecht, Rainer MD∗∗; Bartenstein, Peter MD†,§; Kümpfel, Tania MD§,∥; Danek, Adrian MD∗ Author Information From the Departments of ∗Neurology †Nuclear Medicine ‡Radiology, University Hospital, LMU Munich, Munich §Munich Cluster for Systems Neurology (SyNergy) ∥Institute of Clinical Neuroimmunology, University Hospital and Biomedical Center, Ludwig-Maximilians Universität München ¶Department of Psychiatry and Psychotherapy, LMU Munich, Munich ∗∗Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany. Received for publication February 5, 2020; revision accepted June 10, 2020. Conflicts of interest and sources of funding: N.L.A. gratefully acknowledges the Else Kröner-Fresenius-Stiftung for financial support of her research. J.H. reports a grant for OCT research from the Friedrich-Baur-Stiftung; personal fees and nonfinancial support from Merck, Novartis, Roche, Bayer Healthcare, Santhera, Biogen, and Sanofi Genzyme; and nonfinancial support of the Guthy-Jackson Charitable Foundation, all outside the submitted work. J.H. is (partially) funded by the German Federal Ministry of Education and Research (grants 01ZZ1603[A-D] and 01ZZ1804[A-H] [DIFUTURE]). M.B. and P.B. received speaker honoraria from GE Healthcare. T.K. has received travel expenses and speaker honoraria from Bayer Vital, Teva Pharma, Merck, Novartis Pharma, Sanofi-Aventis/Genzyme, CLS Behring, Roche Pharma, and Biogen, as well as grant support from Bayer-Schering AG, Novartis, and Chugai Pharma. The other authors have none declared. Author Contributions: S.V. and M.U. substantially contributed to study concept and design. L.G., L.K., M.B., and K.A. acquired and interpreted patient data. N.K.A., J.H., M.S., R.R., P.B., T.K., and A.D. revised the manuscript critically for intellectual content. The study was authorized by the local ethics committee (IRB n. 48-15) and the German radiation protection committee in accordance with the ICH Guideline for Good Clinical Practice and the Declaration of Helsinki. All patients gave written consent to participate in the study. Correspondence to: Stefanie Völk, MD, Department of Neurology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany. E-mail: [email protected]. Clinical Nuclear Medicine: October 2020 - Volume 45 - Issue 10 - p e447-e448 doi: 10.1097/RLU.0000000000003220 Buy Metrics Abstract PET targeting the translocator protein (TSPO) expression is an interesting approach to detect neuroinflammation, as TSPO is upregulated in activated macrophages and microglia. Considering the variable pathophysiology of multiple sclerosis (MS) variants, we compare TSPO PET using 18F-GE-180 in 3 different demyelinating diseases of the central nervous system: relapsing-remitting MS, tumefactive MS, and Baló’s concentric sclerosis. Visualization of neuroinflammation and its PET patterns in addition to MRI may contribute to accurate distinction and monitoring of central nervous system demyelination. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.