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18F-FET PET Differentiation of Ring-Enhancing Brain Lesions

Frank W. Floeth1, Dirk Pauleit2, Michael Sabel1, Guido Reifenberger3, Gabriele Stoffels2, Walter Stummer1, Frank Rommel1, Kurt Hamacher4 and Karl-Josef Langen2

1 Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf, Germany; 2 Institute of Medicine and Brain Imaging Center West, Research Center Jülich, Jülich, Germany; 3 Department of Neuropathology, Heinrich-Heine-University, Düsseldorf, Germany; and 4 Institute of Nuclear Chemistry and Brain Imaging Center West, Research Center Jülich, Jülich, Germany


Figure 1
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  		FIGURE 1.  Intracerebral abscess in patient 4. (A) Gadolinium-enhanced MR image shows single right parietal ring-enhancing lesion. (B and D) 18F-FET PET image (B) and 18F-FDG PET image (D) demonstrate significant tracer uptake highly suggestive of malignant neoplastic lesion. (C) Photomicrograph of hematoxylin- and eosin-stained biopsy specimen reveals brain abscess with purulent content and partially necrotic granulocytes in fibrinoid exudations.

 

Figure 2
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  		FIGURE 2.  Demyelinating lesion in patient 7. (A) Gadolinium-enhanced MR image shows single left frontal ring-enhancing lesion. (B) 18F-FET PET image reveals significant uptake indicative of neoplastic lesion. (C) Photomicrograph of biopsy specimen reveals acute demyelinating lesion with massive invasion of macrophages as indicated by immunostaining for CD68. (D) Immunohistochemistry for neurofilaments shows persisting axonal processes but also axonal damage within lesion.

 




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