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METABOLIC IMAGING

[(18)F]-FDG-PET

Pitfalls of [(18)F]-FDG-PET

LGG uptake is similar to normal white matter

HGG uptake is similar to normal gray matter

Cannot differentiate tumour vs inflammation vs acute stroke

Radiation necrosis may be indistinguishable from recurrent tumour

(Due to accumulation of [(18)F]-FDG in macrophages that may infiltrate the sites having received radiation therapy)

High pretreatment glucose metabolic rate is higher in responders to TMZ

than non responders in patients with high grade glioma

(Brock CS. Br J Cancer 2000)