[The role of PET-FDG in questionable diagnosis of relapse in the presence of radionecrosis of brain tumors].
BACKGROUND
Although CT and MR are sensitive techniques for the detection of cerebral tumours, both have limitations in distinguishing between tumour relapse (TR) and post-treatment radionecrosis (RN).


METHODS
In this study we have determined the usefulness of metabolic imaging with PET-FDG in such situations. We assessed 70 patients with CNS tumours (22 low grade astrocytomas, 25 high grade astrocytomas, 3 oligodendrogliomas, 13 metastatic tumours and 7 other tumours. All had been treated with radiotherapy and other treatments such as radiosurgery, chemotherapy or different types of surgery, and presented clinical pictures which made it necessary to decide the differential diagnosis of relapse or radionecrosis.


RESULTS
In the PET-FDG study visual and semiquantitative analysis was done by SUV (Standardized Update Value). Confirmation of the findings was obtained in 44 cases (24 TR and 20 RN). MR was doubtful or inconclusive in most cases, whilst with PET correct diagnosis was made in all cases.


CONCLUSIONS
Metabolic imaging with PET-FGD is better than anatomostructural imaging techniques for differential diagnosis between tumour relapse and radionecrosis in CNS tumours which have been treated. Prospective studies are necessary for evaluation of SUV as a factor for prognosis of survival.
Centro PET Complutense, Fundación Jiménez Díaz, Madrid, España.
C
C
Asensio
M J
MJ
Pérez-Castejón
A
A
Maldonado
R
R
Montz
J A
JA
Ruiz
M
M
Santos
I
I
García-Berrocal
J
J
Albert
J L
JL
Carreras
D000328:Adult; D001254:Astrocytoma / Q000378:metabolism / Q000473:pathology*; D001932:Brain Neoplasms / Q000378:metabolism / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009837:Oligodendroglioma / Q000378:metabolism / Q000473:pathology*; D014055:Tomography, Emission-Computed / Q000379:methods*
Papel de la PET-FDG ante la duda diagnóstica de recidiva frente a radionecrosis en tumores cerebrales.