Combined use of F-18 fluorocholine positron emission tomography and magnetic resonance spectroscopy for brain tumor evaluation.
BACKGROUND
Choline metabolism is often abnormal in malignant brain tumors.


METHODS
Brain positron emission tomography (PET) imaging with F-18 fluorocholine (FCH) was performed on 2 patients with intracranial lesions suspected to be high-grade malignant gliomas on the basis of magnetic resonance (MR) imaging and multivoxel 1H-MR spectroscopic imaging (MRSI) findings. Standardized uptake value (SUV) measurements on PET were compared with measurements of choline/creatine metabolite ratio on MRSI in corresponding regions. Brain biopsy revealed glioblastoma multiforme (GBM) in one case and demyelinating disease in the other.


RESULTS
In the case of GBM, the tumor demonstrated increased FCH uptake on PET. The mean and maximum SUV in areas of the tumor correlated with regional choline/creatine ratio measurements (r = 0.76, P < .001; r = 0.83, P < .001, respectively). In the case of tumefactive demyelinating lesions, the lesion demonstrated low FCH uptake, which did not correlate with choline/creatine ratio measurements.


CONCLUSIONS
Assessments of choline metabolism may aid in evaluating intracranial mass lesions.
Kwee
Sandi A
SA
Hamamatsu/Queen's PET Imaging Center, The Queen's Medical Center, Honolulu, HI 96813, USA. skwee@queens.org
Coel
Marc N
MN
Lim
John
J
Ko
Jehoon P
JP
D000328:Adult; D001921:Brain / Q000378:metabolism; D001932:Brain Neoplasms / Q000175:diagnosis*; D002794:Choline / Q000031:analogs & derivatives*; D003711:Demyelinating Diseases / Q000175:diagnosis; D005260:Female; D005462:Fluorine Radioisotopes; D005909:Glioblastoma / Q000175:diagnosis*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D002794:Choline