Abstract
In a consecutive series of 26 previously operated patients diagnosed with cerebral glioma, magnetic resonance spectroscopy (MRS), 2-((18)F) fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and perfusion MRI (MRP), were performed at follow-up to distinguish recurrence from radiation necrosis, and to identify tumour upgrading. Discrepancy between techniques was observed in 9 cases. The positive predictive value (PPV) and the negative predictive value (NPV) of each technique to detect the presence of high grade glioma was: MRI, PPV=50%; MRS, PPV=91.6%, NPV=100%; FDG-PET, PPV=75%, NPV=61.1%; MRP, PPV=100%, NPV=100%. In the selected group of nine cases studied to differentiate viable tumour from radiation necrosis, MRS and MRP reached a PPV and a NPV of 100%, whereas for FDG-PET, PPV and NPV were 66.6% and 60%, respectively. To distinguish between viable high-grade glioma and radiation necrosis, gadolinium-enhanced MRI gives a high false-positive rate, while MRS and MRP are superior to FDG-PET in discriminating tumour recurrence, grade increase and radiation necrosis.
Copyright (c) 2009 Elsevier Ltd. All rights reserved.
MeSH terms
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Adolescent
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Adult
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Aged
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Brain / diagnostic imaging
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Brain / pathology
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Brain / physiopathology
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Brain Neoplasms / diagnostic imaging
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Brain Neoplasms / pathology*
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Brain Neoplasms / physiopathology
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Diagnosis, Differential
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Disease Progression
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False Positive Reactions
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Female
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Fluorodeoxyglucose F18
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Gadolinium
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Glioma / diagnostic imaging
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Glioma / pathology*
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Glioma / physiopathology
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Humans
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Magnetic Resonance Angiography / methods
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Magnetic Resonance Angiography / statistics & numerical data*
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Magnetic Resonance Spectroscopy / methods
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Magnetic Resonance Spectroscopy / statistics & numerical data*
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Male
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Middle Aged
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Neoplasm Invasiveness / diagnostic imaging
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Neoplasm Invasiveness / pathology
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Neoplasm Invasiveness / physiopathology
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Neoplasm Recurrence, Local / diagnostic imaging
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Neoplasm Recurrence, Local / pathology*
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Neoplasm Recurrence, Local / physiopathology
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Positron-Emission Tomography / methods
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Positron-Emission Tomography / statistics & numerical data*
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Predictive Value of Tests
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Radiotherapy / adverse effects
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Reproducibility of Results
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Retrospective Studies
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Sensitivity and Specificity
Substances
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Fluorodeoxyglucose F18
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Gadolinium