title: Metabolic assessment of monofocal acute inflammatory demyelination using MR spectroscopy and (11)C-methionine-, (11)C-choline-, and (18)F-fluorodeoxyglucose-PET.
abstract: Monofocal acute inflammatory demyelination (MAID), which is observable by CT and MRI as a well-enhanced mass lesion with prominent perifocal edema, is very similar to malignant gliomas radiologically, making differential diagnosis of the two pathologies difficult. The aim of this study was to assess the different metabolic activities between MAID and malignant gliomas by MRS, methionine-PET, choline-PET, and FDG-PET. Six patients with MAID underwent methionine, choline, and FDG-PET, and 4 of the patients also underwent magnetic resonance spectroscopy (MRS). The images obtained from these patients were compared with the corresponding images of 19 anaplastic astrocytomas (AA) and 21 glioblastomas (GBM). The mean choline/creatine ratio of MAID was significantly lower than that of GBM. There were no significant differences in the mean NAA/creatine and lactate/creatine ratios among these pathologies. The methionine T/N ratio of MAID was significantly lower than those of AA and GBM. The choline T/N ratio of MAID was significantly lower than that of GBM. There were no significant differences in the FDG T/N ratios among these pathologies. These results demonstrate that the metabolic activity of MAID significantly differs in part from that of malignant gliomas. Combined PET and MRS neuroimaging examinations may be useful for differential diagnosis of these pathologies.
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, 630 Shimo-Kobi, Kobi-cho, Minokamo, Gifu 505-0034, Japan. syunsuke826@yahoo.co.jp
authors: Shunsuke
authors: S
authors: Takenaka
authors: Jun
authors: J
authors: Shinoda
authors: Yoshitaka
authors: Y
authors: Asano
authors: Tatsuki
authors: T
authors: Aki
authors: Kazuhiro
authors: K
authors: Miwa
authors: Takeshi
authors: T
authors: Ito
authors: Kazutoshi
authors: K
authors: Yokoyama
authors: Toru
authors: T
authors: Iwama
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D002250:Carbon Radioisotopes; D002794:Choline; D003401:Creatine; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D019344:Lactic Acid; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008715:Methionine; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*
chemical_list: D002250:Carbon Radioisotopes; D019788:Fluorodeoxyglucose F18; D019344:Lactic Acid; D008715:Methionine; D003401:Creatine; D002794:Choline