Japanese Journal of Radiology

, Volume 36, Issue 4, pp 303–311 | Cite as

Remote effects in the ipsilateral thalamus and/or contralateral cerebellar hemisphere using FDG PET in patients with brain tumors

  • Hitomi Iwasa
  • Yoriko Murata
  • Miki Nishimori
  • Kana Miyatake
  • Michiko Tadokoro
  • Shino Kohsaki
  • Munenobu Nogami
  • Yusuke Ueba
  • Tetsuya Ueba
  • Takuji Yamagami
Original Article



To evaluate reduced metabolism in the ipsilateral thalamus (TH) and/or contralateral cerebellum (CE) according to tumor localization and cortical metabolism around the tumor in patients with brain tumors based on FDG uptake.


This study investigated 48 consecutive patients with solitary cerebral hemisphere parenchymal brain tumors who underwent PET/CT and MRI. Patients were divided into 4 groups (A: reduced uptake in ipsilateral TH and contralateral CE, B: reduced uptake in ipsilateral TH only, C: reduced uptake in contralateral CE only, and D: no reduced uptake in ipsilateral TH or contralateral CE). FDG uptake and MRI findings were compared among these groups.


Of 48 patients, group A included 24 (50%), group B included 10 (21%), group C included 0, and group D included 14 (29%). No significant tendencies were observed between the groups regarding tumor localization. However, reduced cortical metabolism around the tumor was observed in 22 patients in group A, 7 patients in group B, and 1 patient in group D. All patients in group B showed reduced metabolism from around the tumor up to the ipsilateral TH.


Reduced FDG uptake in ipsilateral TH and contralateral CE usually occur simultaneously in patients with solitary brain tumors.


Brain tumor Ipsilateral thalamus Contralateral cerebellum FDG-PET/CT 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Feeney DM, Baron JC. Diaschisis. Stroke. 1986;17:817–30.CrossRefPubMedGoogle Scholar
  2. 2.
    Baron JC, Bousser MG, Comar D, Castaigne P. Crossed cerebellar diaschisis” in human supratentorial brain infarction. Trans Am Neurol Assoc. 1981;105:459–61.PubMedGoogle Scholar
  3. 3.
    Kuhl DE, Phelps ME, Kowell AP, Metter EJ, Selin C, Winter J. Effects of stroke on local cerebral metabolism and perfusion: mapping by emission computed tomography of 18FDG and 13NH3. Ann Neurol. 1980;8:47–60.CrossRefPubMedGoogle Scholar
  4. 4.
    Fujie W, Kirino T, Tomukai N, Iwasawa T, Tamura A. Progressive shrinkage of the thalamus following middle cerebral artery occlusion in rats. Stroke. 1990;21:1485–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Iizuka H, Sakatani K, Young W. Neural damage in the rat thalamus after cortical infarcts. Stroke. 1990;21:790–4.CrossRefPubMedGoogle Scholar
  6. 6.
    Nagasawa H, Kogure K. Exo-focal postischemic neuronal death in the rat brain. Brain Res. 1990;524:196–202.CrossRefPubMedGoogle Scholar
  7. 7.
    Tamura A, Kirino T, Sano K, Takagi K, Oka H. Atrophy of the ipsilateral substantia nigra following middle cerebral artery occlusion in the rat. Brain Res. 1990;510:154–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Kataoka K, Hayakawa T, Yamada K, Mushiroi T, Kuroda R, Mogami H. Neuronal network disturbance after focal ischemia in rats. Stroke. 1989;20:1226–35.CrossRefPubMedGoogle Scholar
  9. 9.
    Nagasawa H, Kogure K, Fujiwara T, Itoh M, Ido T. Metabolic disturbances in exo-focal brain areas after cortical stroke studied by positron emission tomography. J Neurol Sci. 1994;123:147–53.CrossRefPubMedGoogle Scholar
  10. 10.
    Ogawa T, Yoshida Y, Okudera T, Noguchi K, Kado H, Uemura K. Secondary thalamic degeneration after cerebral infarction in the middle cerebral artery distribution: evaluation with MR imaging. Radiology. 1997;204:255–62.CrossRefPubMedGoogle Scholar
  11. 11.
    Patronas NJ, Di Chiro G, Smith BH, De La Paz R, Brooks RA, Milam HL, et al. Depressed cerebellar glucose metabolism in supratentorial tumors. Brain Res. 1984;291:93–101.CrossRefPubMedGoogle Scholar
  12. 12.
    Calabria F, Schillaci O. Recurrent glioma and crossed cerebellar diaschisis in a patient examined with 18F-DOPA and 18F-FDG PET/CT. Clin Nucl Med. 2012;37:878–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Kajimoto K, Oku N, Kimura Y, Kato H, Tanaka MR, Kanai Y, et al. Crossed cerebellar diaschisis: a positron emission tomography study with L-[methyl-11C]methionine and 2-deoxy-2-[18F]fluoro-D-glucose. Ann Nucl Med. 2007;21:109–13.CrossRefPubMedGoogle Scholar
  14. 14.
    Teoh EJ, Green AL, Bradley KM. Crossed cerebellar diaschisis due to cerebral diffuse large B cell lymphoma on 18F-FDG PET/CT. Int J Hematol. 2014;100:415–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Otte A, Roelcke U, von Ammon K, Hausmann O, Maguire RP, Missimer J, et al. Crossed cerebellar diaschisis and brain tumor biochemistry studied with positron emission tomography, [18F]fluorodeoxyglucose and [11C]methionine. J Neurol Sci. 1998;156:73–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Han S, Wang X, Xu K, Hu C. Crossed cerebellar diaschisis: three case reports imaging using a tri-modality PET/CT-MR system. Medicine. 2016;95:e2526.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48:452–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Israel O, Delbeke D. Normal distribution, variants, pitfalls, and artifacts. In: Delbeke D, Israel O, editors. Hybrid PET/CT and SPECT/CT imaging. New York: Springer Science + Business; 2010. p. 35–96.CrossRefGoogle Scholar
  19. 19.
    Brodal A. Cerebrocerebellar pathways. Anatomical data and some functional implications. Acta Neurol Scand Suppl. 1972;51:153–95.PubMedGoogle Scholar
  20. 20.
    Kang KM, Sohn CH, Kim BS, Kim YI, Choi SH, Yun TJ, et al. Correlation of asymmetry indices measured by arterial spin-labeling MR imaging and SPECT in patients with crossed cerebellar diaschisis. Am J Neuroradiol. 2015;36:1662–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Pantano P, Baron JC, Samson Y, Bousser MG, Derouesne C, Comar D. Crossed cerebellar diaschisis. Further studies. Brain. 1986;109:677–94.CrossRefPubMedGoogle Scholar
  22. 22.
    Kushner M, Alavi A, Reivich M, Dann R, Burke A, Robinson G. Contralateral cerebellar hypometabolism following cerebral insult: a positron emission tomographic study. Ann Neurol. 1984;15:425–34.CrossRefPubMedGoogle Scholar
  23. 23.
    Flint AC, Naley MC, Wright CB. Ataxic hemiparesis from strategic frontal white matter infarction with crossed cerebellar diaschisis. Stroke. 2006;37:e1–2.CrossRefPubMedGoogle Scholar
  24. 24.
    Infeld B, Davis SM, Lichtenstein M, Mitchell PJ, Hopper JL. Crossed cerebellar diaschisis and brain recovery after stroke. Stroke. 1995;26:90–5.CrossRefPubMedGoogle Scholar
  25. 25.
    Miyazawa N, Toyama K, Arbab AS, Koizumi K, Arai T, Nukui H. Evaluation of crossed cerebellar diaschisis in 30 patients with major cerebral artery occlusion by means of quantitative I-123 IMP SPECT. Ann Nucl Med. 2001;15:513–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Komaba Y, Mishina M, Utsumi K, Katayama Y, Kobayashi S, Mori O. Crossed cerebellar diaschisis in patients with cortical infarction: logistic regression analysis to control for confounding effects. Stroke. 2004;35:472–6.CrossRefPubMedGoogle Scholar

Copyright information

© Japan Radiological Society 2018

Authors and Affiliations

  1. 1.Department of Radiology, Kochi Medical SchoolKochi UniversityNankokuJapan
  2. 2.Department of RadiologyHealth care system JINSEI-KAI Hosogi HospitalKochiJapan
  3. 3.Department of RadiologyKobe University HospitalKobeJapan
  4. 4.Department of Neurosurgery, Kochi Medical SchoolKochi UniversityNankokuJapan

Personalised recommendations