Multimodality assessment of brain tumors and tumor recurrence

J Nucl Med. 2011 Oct;52(10):1585-600. doi: 10.2967/jnumed.110.084210. Epub 2011 Aug 12.

Abstract

Neuroimaging plays a significant role in the diagnosis of intracranial tumors, especially brain gliomas, and must consist of an assessment of location and extent of the tumor and of its biologic activity. Therefore, morphologic imaging modalities and functional, metabolic, or molecular imaging modalities should be combined for primary diagnosis and for following the course and evaluating therapeutic effects. MRI is the gold standard for providing detailed morphologic information and can supply some additional insights into metabolism (MR spectroscopy) and perfusion (perfusion-weighted imaging) but still has limitations in identifying tumor grade, invasive growth into neighboring tissue, and treatment-induced changes, as well as recurrences. These insights can be obtained by various PET modalities, including imaging of glucose metabolism, amino acid uptake, nucleoside uptake, and hypoxia. Diagnostic accuracy can benefit from coregistration of PET results and MRI, combining the high-resolution morphologic images with the biologic information. These procedures are optimized by the newly developed combination of PET and MRI modalities, permitting the simultaneous assessment of morphologic, functional, metabolic, and molecular information on the human brain.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Amino Acids / metabolism
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / metabolism
  • Diffusion Magnetic Resonance Imaging
  • Education, Medical, Continuing
  • Fluorodeoxyglucose F18
  • Glioma / diagnosis
  • Glioma / diagnostic imaging
  • Glioma / metabolism
  • Glucose / metabolism
  • Humans
  • Hypoxia, Brain / diagnosis
  • Hypoxia, Brain / diagnostic imaging
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / metabolism
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Receptors, Somatostatin / metabolism
  • Tomography, X-Ray Computed

Substances

  • Amino Acids
  • Radiopharmaceuticals
  • Receptors, Somatostatin
  • Fluorodeoxyglucose F18
  • Glucose