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ORIGINAL ARTICLE
Year : 2011  |  Volume : 26  |  Issue : 4  |  Page : 171-176

Role of 18 F-fluorodeoxyglucose Positron Emission Tomography scan in differentiating enhancing brain tumors


1 Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
4 Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Kajal Das
Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.106698

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Aim: To determine whether F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) can be used to differentiate among common enhancing brain tumors such as gliomas, metastatic brain tumors, and lymphoma. Materials and Methods: We evaluated 20 patients with an enhancing brain tumor on magnetic resonance imaging (MRI). FDG PET scan was done in all patients pre operatively. For PET image analysis, regions of interest were placed over the tumor (T), contralateral cortex (C), and white matter (WM). Average and maximum pixel values were determined at each site. On the basis of these measurements, average and maximum standard uptake values (SUV avg and SUV max ) were calculated, and comparisons among lesions were then made. Results: SUV avg and SUV max are significantly higher for central nervous system (CNS) lymphoma than for other tumors ( P < 0.01). High-grade gliomas showed significantly higher SUV avg and SUV max than the low grade gliomas ( P < 0.05) and metastatic tumor showed higher SUV avg and SUV max than all gliomas, both low and high grade ( P < 0.05). When the lowest values of CNS lymphoma parameter were used as cutoff levels to distinguish CNS lymphomas from other tumors (i.e. 100% sensitivity), SUV max was the most accurate parameter. Using a SUV max of 15.0 as a cutoff for diagnosing CNS lymphoma, only one case of metastasis (SUV max , 16.3) was found to be false positive in this study. Conclusion: FDG PET appears to provide additional information for differentiating common enhancing malignant brain tumors, namely lymphoma versus high grade glioma and metastatic tumor, particularly when differential diagnoses are difficult to narrow using MRI alone.


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