Brain tumor imaging with FDG PET or FDG PET CT is often difficult to interpret, due to several limiting factors, including high background FDG uptake in the brain parenchyma especially the cerebral/cerebellar cortices and basal ganglia, the heterogeneity of primary and metastatic brain tumors with widely variable FDG uptake, and the altered brain and tumor glucose metabolic activity due to posttreatment changes (Chen, J Nucl Med 48(9):1468–1481, 2007; Demetriades et al., Surgeon 12(3):148–157, 2014; Hustinx and Fosse, PET Clin 5(2):185–197, 2010). Nevertheless, as shown in this chapter, FDG PET could provide unique tumor metabolic features that may guide accurate biopsy of brain tumors with uneven metabolic activity, help differentiate tumor recurrence from post-radiation necrosis, and facilitate pre-surgical brain tumor grading and treatment planning (Chen, J Nucl Med 48(9):1468–1481, 2007). Due to the overall suboptimal detection sensitivity of FDG PET, correlation of suspicious FDG PET findings with diagnostic brain MRI and/or CT is always recommended. Presented in this chapter are highly selected cases showing the value and limitation of FDG PET imaging in the evaluation of primary and recurrent glioblastoma multiforme (GBM), primary and secondary central nerve system (CNS) lymphomas, ganglioglioma, leptomeningeal melanoma, and metastatic lung and breast cancers to the brain.
FDG PET Brain tumors Glioblastoma CNS lymphoma Melanoma Brain metastasis
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Barnholtz-Sloan JS, Sloan AE, Davis FG, et al. Incidence proportions of brain metastases in patients diagnosed (1973-2001) in the Metropolitan Detroit Cancers Surveillance System. J Clin Oncol. 2004;22:2865–72.CrossRefGoogle Scholar
Malikova H, Burghardtova M, Koubska E, et al. Secondary central nervous system lymphoma: spectrum of morphological MRI appearances. Neuropsychiatr Dis Treat. 2018;14:733–40.CrossRefGoogle Scholar
Schouten LJ, Rutten J, Huveneers HA, et al. Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer. 2002;94:2698–705.CrossRefGoogle Scholar
Seqtnan EA, Hess S, Grupe P, et al. 18F-fluorodeoxyglucose PET/computed tomography for primary brain tumors. PET Clin. 2015;10(1):59–73.CrossRefGoogle Scholar
Tang YZ, Booth TC, Bhogal P, et al. Imaging of primary central nervous system lymphoma. Clin Radiol. 2011;66(8):768–077.CrossRefGoogle Scholar
Wang X, Hu X, Xie P, et al. Comparison of magnetic resonance spectroscopy and positron emission tomography in detection of tumor recurrence in posttreatment of glioma: a diagnostic meta-analysis. Asia Pac J Clin Oncol. 2015;11(2):97–105.CrossRefGoogle Scholar