Relative value of magnetic resonance spectroscopy, magnetic resonance perfusion, and 2-(18F) fluoro-2-deoxy-D-glucose positron emission tomography for detection of recurrence or grade increase in gliomas.
In a consecutive series of 26 previously operated patients diagnosed with cerebral glioma, magnetic resonance spectroscopy (MRS), 2-((18)F) fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and perfusion MRI (MRP), were performed at follow-up to distinguish recurrence from radiation necrosis, and to identify tumour upgrading. Discrepancy between techniques was observed in 9 cases. The positive predictive value (PPV) and the negative predictive value (NPV) of each technique to detect the presence of high grade glioma was: MRI, PPV=50%; MRS, PPV=91.6%, NPV=100%; FDG-PET, PPV=75%, NPV=61.1%; MRP, PPV=100%, NPV=100%. In the selected group of nine cases studied to differentiate viable tumour from radiation necrosis, MRS and MRP reached a PPV and a NPV of 100%, whereas for FDG-PET, PPV and NPV were 66.6% and 60%, respectively. To distinguish between viable high-grade glioma and radiation necrosis, gadolinium-enhanced MRI gives a high false-positive rate, while MRS and MRP are superior to FDG-PET in discriminating tumour recurrence, grade increase and radiation necrosis.
Prat
R
R
Department of Neurosurgery, Hospital Universitario La Fe Avda, Campanar 21, Valencia 46009, Spain.
Galeano
I
I
Lucas
A
A
Martínez
J C
JC
Martín
M
M
Amador
R
R
Reynés
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D005682:Gadolinium; D005910:Glioma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods / Q000706:statistics & numerical data*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D049268:Positron-Emission Tomography / Q000379:methods / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011878:Radiotherapy / Q000009:adverse effects; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D019788:Fluorodeoxyglucose F18; D005682:Gadolinium