[18F]2-fluoro-2-deoxyglucose-positron emission tomography correlation of gadolinium-enhanced MR imaging of central nervous system neoplasia.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
W K
WK
Davis
O B
OB
Boyko
J M
JM
Hoffman
M W
MW
Hanson
S C
SC
Schold
P C
PC
Burger
A H
AH
Friedman
R E
RE
Coleman
D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D005260:Female; D019788:Fluorodeoxyglucose F18; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D014055:Tomography, Emission-Computed
D003287:Contrast Media; D009942:Organometallic Compounds; D019788:Fluorodeoxyglucose F18; D004369:Pentetic Acid; D003847:Deoxyglucose; D019786:Gadolinium DTPA