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Diagnosis and Evaluation
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40th
ASCO Annual Meeting. New Orleans, LA. June 5-8, 2004. Abstract No.1551 (Clinical
Study)
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Meeting Abstract |
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Concordance of FDG-PET scan and MRI- spectroscopy in primary and metastatic
intracranial tumors
S. M. Kurian, E. B. Crowell
West Virginia University, Morgantown, WV
Background. Functional imaging techniques that utilize altered metabolic
characteristics like glycolytic activity (PET scan) and catabolic metabolites
(spectroscopy) in neoplastic tissues are powerful tools that add to our ability
to non-invasively characterize intracranial lesions.
We are presenting the
results of a single institution experience, evaluating the concordance between
PET scan and MRI spectroscopy and analyzing the relative contributions of these
two imaging modalities.
Methods. Thirteen patients with intracranial mass
underwent both MRI spectroscopy and FDG-PET scan in our institution.
The median
interval between these two studies was two weeks.
The presence of a high SUV
hypermetabolic activity was considered as positive PET result and reversal of
choline:creatinine ratio exceeding 2 was considered as positive spectroscopic
result.
Results. Concordance between the two modalities was found in
eight (both tests positive in four, both tests negative in four ) patients out
of the total thirteen patients.
Further follow-up with tissue diagnosis of
patients with double positive results showed that these results correlated
accurately with their subsequent pathological diagosis of a malignant
intracranial neoplastic process.
Patients with both results negative had
non-malignant process ( multiple sclerosis, toxoplasmosis).
In the five patients
with discordent results, PET scan alone was positive in three patients
(metastatic lung cancer with brain metastasis-2, radiation necrosis-1).
In the
other two patients with discordant results, only spectroscopy was positive, and
they were diagnosed with low grade primary malignant gliomas.
Conclusions.
Concordance between these two tests correlated with accurately predicting
neoplastic nature of the tumor.
PET scan was relatively more accurate in
detecting metastatic lesions to brain.
Spectroscopy was more reliable in
detection of primary brain neoplasm including low grade tumors and in the
differentiation of radiation necrosis.
These two techniques can be used as
complementary imaging modalities to improve the non-invasive diagnostic yield in
patients with intracranial lesions.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-00575,00.asp
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