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CC BY-NC-ND 4.0 · World J Nucl Med 2019; 18(03): 266-272
DOI: 10.4103/wjnm.WJNM_89_18
Original Article

Utility of FET-PET in detecting high-grade gliomas presenting with equivocal MR imaging features

Ameya D. Puranik
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Mathew Boon
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Nilendu Purandare
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Venkatesh Rangarajan
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Tejpal Gupta
1   Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Aliasgar Moiyadi
2   Department of Neurosurgery, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Prakash Shetty
2   Department of Neurosurgery, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Epari Sridhar
3   Department of Pathology, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Archi Agrawal
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Indraja Dev
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
,
Sneha Shah
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University, Mumbai, Maharashtra, India
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Abstract

High-grade gliomas, metastases, and primary central nervous system lymphoma (PCNSL) are common high-grade brain lesions, which may have overlapping features on magnetic resonance (MR) imaging. Our objective was to assess the utility of 18-fluoride-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) in reliably differentiating between these lesions, by studying their metabolic characteristics. Patients with high-grade brain lesions suspicious for glioma, with overlapping features for metastases and PCNSL were referred for FET-PET by Neuroradiologists from Multidisciplinary Neuro-Oncology Joint Clinic. Tumor-to-contralateral white mater ratio (T/Wm) at 5 and 20 min was derived and compared to histopathology. Receiver operating characteristic curve analysis was used to find the optimal T/Wm cutoff to differentiate between the tumor types. T/Wm was higher for glial tumors compared to nonglial tumors (metastases, PCNSL, tuberculoma, and anaplastic meningioma). A cutoff of 1.9 was derived to reliably diagnose a tumor of glial origin with a sensitivity and specificity of 93.8% and 91%, respectively. FET-PET can be used to diagnose glial tumors presenting as high-grade brain lesions when MR findings show overlapping features for other common high-grade lesions.

Keywords

Brain lesions - fluoroethyl-tyrosine-positron-emission tomography - high-grage glioma - magnetic resonance imaging

Financial support and sponsorship

Nil.




Publication History

Received: 19 October 2018

Accepted: 09 November 2018

Article published online:
22 April 2022

© 2019. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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