Distinguishing pseudoprogression from progression in high-grade gliomas: a brief review of current clinical practice and demonstration of the potential value of 18F-FDG PET

Clin Nucl Med. 2013 May;38(5):381-4. doi: 10.1097/RLU.0b013e318286c148.

Abstract

We report a case in which 18F-FDG PET was able to discriminate pseudoprogression from progression observed on contrast-enhanced (CE) MRI (CE-MRI). A 56-year-old male patient with anaplastic oligodendroglioma demonstrated markedly increased tumor enhancement on CE-MRI 1 month after completing radiation therapy (RT), suggesting radiological progression. However, the patient was clinically improved and therefore received an early-therapy response assessment PET to assess for pseudoprogression. PET showed low tumor uptake indicating stable disease. Follow-up CE-MRI at 3 and 4 months post-RT confirmed stable disease. This case emphasizes the value of 18F-FDG PET when pseudoprogression is clinically suspected.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Diagnosis, Differential
  • Disease Progression*
  • Fluorodeoxyglucose F18*
  • Glioma / diagnostic imaging*
  • Glioma / pathology*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Positron-Emission Tomography*

Substances

  • Fluorodeoxyglucose F18