RT Journal Article SR Electronic T1 Inflammatory Demyelinating Disease Mimicking Malignant Glioma JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 565 OP 569 VO 44 IS 4 A1 Toshiaki Hayashi A1 Toshihiro Kumabe A1 Hidefumi Jokura A1 Kazuo Fujihara A1 Yusei Shiga A1 Mika Watanabe A1 Shu-ichi Higano A1 Reizo Shirane YR 2003 UL http://jnm.snmjournals.org/content/44/4/565.abstract AB The differential diagnosis between inflammatory demyelinating disease and malignant glioma is difficult based only on neuroimaging methods. Methods: Four patients with inflammatory demyelinating disease who presented with clinical and neuroimaging findings strongly suggestive of malignant glioma were examined. Results: MRI showed a mass lesion with prolonged T1 and T2 values and gadolinium enhancement in all cases. Proton MR spectroscopy and 201Tl SPECT showed findings supportive of the diagnosis of malignant glioma in all cases. However, surgical biopsy revealed inflammatory demyelinating disease. After the diagnosis, 2 patients were treated by steroid administration and 2 were just observed. The gadolinium enhancement of all lesions decreased and finally disappeared. Conclusion: Such cases illustrate the importance of considering a demyelinating lesion in the differential diagnosis of a mass lesion. The difficulties encountered in establishing the correct diagnosis of inflammatory disease are related to the variations in the radiologic appearance, which require exclusion of gliomas or other brain tumors by surgical biopsy before the therapeutic strategy can be selected.