Comparison of serial PET and MRI scans in a pediatric patient with a brainstem glioma.
Profound clinical deficits may be associated with insults to the brainstem, making management of patients with brainstem gliomas very complex. Small changes in the radiographic appearance of a brainstem tumor may be associated with significant clinical deterioration. Furthermore, both magnetic resonance imaging and computed tomography are frequently unable to differentiate between therapy-related tissue reactions and progressive tumor. Two clinical scenarios particularly difficult to resolve include: (1) transient radiographic and clinical deterioration following hyperfractionated radiotherapy, and (2) clinical deterioration in a patient who has failed initial therapy, but has stable radiographic findings following a second therapy. We report a child with a pontine glioma whose tumor progression was demonstrated more convincingly with a 18F-deoxyglucose positron emission scan than with magnetic resonance imaging. PET scans may be helpful in confirming that tumor progression is responsible for clinical deterioration in a patient whose MRI scans remain stable.
Bruggers
C S
CS
Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710.
Friedman
H S
HS
Fuller
G N
GN
Tien
R D
RD
Marks
L B
LB
Halperin
E C
EC
Hockenberger
B
B
Oakes
W J
WJ
Hoffman
J M
JM
D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D001933:Brain Stem; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D011859:Radiography; D014055:Tomography, Emission-Computed
D003907:Dexamethasone; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003520:Cyclophosphamide