Use of [18F]fluorodeoxyglucose positron emission tomography in patients with primary malignant brain tumors.
In patients with malignant gliomas, [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) may discriminate tumor progression from radionecrosis. We evaluated data from 50 patients undergoing FDG-PET for suspicion of tumor progression. Forty-nine were treated with surgery, 48 with radiotherapy, and 37 with chemotherapy. Twenty-one had intensive radiotherapy with either three daily treatments in two 5-day periods and intravenous carboplatin (17) or interstitial brachytherapy or stereotactic radiotherapy. Twenty underwent surgery after magnetic resonance imaging/FDG-PET; 9 demonstrated increased uptake of FDG and evidence of tumor, whereas 6 had decreased uptake and no evidence of tumor. In 5 patients, there was no correlation (all had intensive radiotherapy). In 17 patients who received bromodeoxyuridine intravenously just before surgery, the bromodeoxyuridine labeling index corresponded to the histological appearance in all but 2 patients (both had received intensive radiotherapy). In 30 patients without surgery, decreased uptake of FDG suggested prolonged survival; increased uptake of FDG did not predict survival. Eight of 10 with intensive radiotherapy had decreased label uptake. We conclude FDG-PET for evaluation of patients with possible recurrent tumors requires more study. In patients with intensive radiotherapy, FDG-PET results cannot be correlated accurately with tumor progression.
Department of Neurology, College of Medicine, University of Iowa, Iowa City.
T J
TJ
Janus
E E
EE
Kim
R
R
Tilbury
J M
JM
Bruner
W K
WK
Yung
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage; D012008:Recurrence; D013238:Stereotaxic Techniques; D014055:Tomography, Emission-Computed
D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose