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Carbon-11-Methionine and Fluorine-18-FDG PET Study in Brain Hematoma

Services de Neurologie et de Neurochirurgie and the PET/Biomedical Cyclotron Unit, ULB-Hôpital Erasme, Brussels, Belgium

Correspondence: For correspondence and reprints contact: Sophie Dethy, MD, Service de Neurologie, ULB-Hôpital Erasme, 808, route de Lennik, B-1070 Brussels, Belgium.

ABSTRACT

Three patients were examined using PET with L-methyl-¹¹C-methionine (¹¹C-methionine) and 2-¹⁸F-fluoro-2-deoxy-D-glucose (FDG) 20 to 32 days after the occurrence of nontumoral brain hematomas. PET revealed high uptake of ¹¹C-methionine in the area surrounding the hematoma in all three patients. In two patients, discrete spots of moderate uptake of FDG were found at the periphery of a hypometabolic area. PET studies were repeated in two patients 76 and 103 days after the bleeding, respectively, and showed a dramatic decrease in ¹¹C-methionine uptake around the hematoma. The spots of FDG uptake disappeared on the repeated late scans. We hypothesize that the subacute gliotic reaction surrounding brain hematomas is responsible for increased uptake of ¹¹C-methionine and for the presence of spots of FDG uptake. PET studies with ¹¹C-methionine and FDG performed 20 to 32 days after the initial symptom are not helpful in the differentiation between neoplastic and non-neoplastic origins of an intracerebral hemorrhage since tracer uptake at the periphery of the lesion may be increased in both.

Key Words: PET • brain hematoma • carbon-11-methionine • FDG

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