Comparison between MR Perfusion and 18F-FDG PET in Differentiating Tumor Recurrence from Nonneoplastic...

Area of Science:

• Neuroimaging
• Oncology
• Radiology

Background:

• Distinguishing tumor recurrence from non-neoplastic contrast-enhancing tissue post-treatment is crucial for effective patient management.
• Both MR perfusion and 18-FDG-PET are utilized for this diagnostic challenge, but their comparative accuracy is debated.

Purpose of the Study:

• To compare the diagnostic accuracy of MR perfusion and 18-FDG-PET in differentiating recurrent brain tumors from non-neoplastic contrast-enhancing tissue.

Main Methods:

• A retrospective review of MR perfusion and 18-FDG-PET data was conducted in 28 patients with primary brain tumors or metastatic lesions.
• The study included 17 high-grade and 6 low-grade glial neoplasms, along with 5 cases of metastatic lesions exhibiting enhancing lesions on post-treatment MRI.

Main Results:

• Both cerebral blood volume (CBV) on MR perfusion and standardized uptake value (SUV) on 18-FDG-PET were significantly higher in recurrent tumors compared to necrotic tissue (p<0.004 for CBV, p<0.02 for SUV).
• MR perfusion achieved an accuracy of 94.5% in differentiating tumor recurrence from necrosis.
• 18-FDG-PET demonstrated an accuracy of 85.1% in differentiating tumor recurrence from non-neoplastic contrast-enhancing tissue.

Conclusions:

• Recurrent tumors exhibit significantly higher CBV and SUV compared to non-neoplastic enhancing tissue.
• MR perfusion imaging appears to be more accurate than 18-FDG-PET for distinguishing between recurrent brain tumors and non-neoplastic contrast-enhancing tissue.