American Journal of Neuroradiology, Vol 14, Issue 3 515-523, Copyright © 1993 by American Society of Neuroradiology
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[18F]2-fluoro-2-deoxyglucose-positron emission tomography correlation of gadolinium-enhanced MR imaging of central nervous system neoplasia
WK Davis, OB Boyko, JM Hoffman, MW Hanson, SC Schold Jr, PC Burger, AH Friedman and RE Coleman
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
PURPOSE: To correlate the findings of gadolinium- diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced MR imaging with positron emission tomography (PET) in the evaluation of central nervous system neoplasia. MATERIALS AND METHODS: Thirty-six lesions identified on noncontrast MR in 35 patients with biopsy-proved intracranial tumors were imaged with both T1-weighted Gd-DTPA MR at 1.5 T and [18F]2-fluoro- 2-deoxyglucose (FDG) positron emission tomography (PET). Eighteen women and 17 men with a mean age of 47.1 years (range 22-72) were studied. The degrees of Gd-DTPA enhancement and FDG uptake were rated separately, and then all scans were reviewed together. FDG uptake was graded 1-5. RESULTS: Of the 35 lesions rated, 30 had Gd-DTPA enhancement and 28 of these were hypermetabolic (FDG accumulation greater than white matter) on PET (93% concordance). Twenty-six of 32 neoplastic lesions had Gd-DTPA enhancement. Twenty-four of these enhancing tumors were hypermetabolic. Only one lesion was completely missed on PET but identified on routine spin echo MR. CONCLUSION: Gd- DTPA MR and FDG-PET are complementary and there is a high concordance of Gd-DTPA-enhancing tumours displaying FDG hypermetabolism. Although FDG hypermetabolism and Gd-DTPA enhancement are usually suggestive of high-grade malignancy, anaplastic astrocytomas may not enhance with Gd- DTPA and can be hypometabolic. In addition, benign intracranial tumors (two cases of meningioma) and radiation necrosis can be associated with both FDG uptake and Gd-DTPA enhancement.
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