PET in Differentiation of Recurrent Brain Tumor from Radiation Injury

• Published in: The Journal of nuclear medicine (1978) Vol. 41; no. 11; pp. 1861 - 1867
• Main Authors: Langleben, Daniel D, Segall, George M
• Format: Journal Article
• Language: English
• Published: Reston, VA Soc Nuclear Med 01.11.2000; Society of Nuclear Medicine
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Brain - diagnostic imaging; Brain - radiation effects; Brain Neoplasms - diagnostic imaging; Diagnosis, Differential; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Humans; Intensive care medicine; Medical sciences; Neoplasm Recurrence, Local - diagnostic imaging; Neurology; Radiation Injuries - diagnostic imaging; Radiography; Radionuclide Imaging; Sensitivity and Specificity; Tumors of the nervous system. Phacomatoses; Radionuclide study; Human; Evaluation; Intracranial; Nervous system diseases; Relapse; Glucose; Malignant tumor; Metabolism; Radiotherapy; Differential diagnostic; Cerebral disorder; Sensitivity; Central nervous system disease; Radiation injury; Complication; Positron; Emission tomography
• ISSN: 0161-5505; 1535-5667

The annual incidence of primary intracranial tumors is 7 to 19 cases per 100,000 people. The general approach to the treatment of brain neoplasms is surgical resection of solitary lesions or limited disease, followed by radiation therapy with or without chemotherapy. Multiple metastatic lesions are usually treated with whole-brain radiation. Radiation injury occurs in 5% to 37% of cases and can be difficult to differentiate from residual or recurrent malignancy by MRI. PET has been used to differentiate radiation injury from malignancy on the basis of differences in glucose uptake. Recent studies have reported the sensitivity and specificity of PET to be 81% to 86% and 40% to 94%, respectively. This article reviews the classification of primary brain tumors, the histologic changes associated with radiation injury, and the diagnostic and prognostic information provided by PET.