Brain Tumor Case 01


Clinical History
A 64-year-old woman with a diagnosis of glioblastoma multiforme, an aggressive brain tumor, was operated on to remove the tumor and was then treated with radiation.

Imaging Findings

MRI FINDINGS: The contrast-enhanced MRI image (left image) showed an area of contrast accumulation near the surgical region (white arrow), which suggested possible tumor recurrence.

NUCLEAR MEDICINE PET
STATED REASON FOR REQUEST: Follow-up after surgery and radiation treatment
COMPARISON: Recent MRI for suspected tumor recurrence

PET FINDINGS: The PET scan (right image) showed there was no corresponding radiopharmaceutical uptake in the region of contrast accumulation seen on the MRI scan. These results suggested that the contrast enhancement observed in the MR image was the result of radiation necrosis and that no residual tumor was present at that time.

Discussion
The preferred treatment for brain tumors is surgical removal and PET scans are useful for evaluating the efficacy of surgical procedures. In this case, PET helped by showing the physician that an inconclusive finding on MRI was, in fact, scar tissue as a result of radiation and not residual tumor. Therefore, this patient did not need medical or surgical intervention at that time.

Data by permission of the Society of Nuclear Medicine

Gambhir SS, Czernin J, Schwimmer J, et al. A Tabulated Summary of the FDG PET Literature. J Nucl Med 2001; 42(5 Suppl); 32S, Figure 7.

Any of the protocols presented herein are for informational purposes and are not meant to substitute for clinician judgment in how best to use any medical devices. It is the clinician that makes all diagnostic determinations based upon education, learning and experience.