FDG-PET IN THE SELECTION OF BRAIN-LESIONS FOR BIOPSY

被引:62
作者
HANSON, MW
GLANTZ, MJ
HOFFMAN, JM
FRIEDMAN, AH
BURGER, PC
SCHOLD, SC
COLEMAN, RE
机构
[1] DUKE UNIV,MED CTR,DEPT MED,DIV NEUROL,DURHAM,NC 27710
[2] DUKE UNIV,MED CTR,DEPT SURG,DIV NEUROSURG,DURHAM,NC 27710
[3] DUKE UNIV,MED CTR,DEPT PATHOL,DURHAM,NC 27710
[4] UNIV MINNESOTA,SCH MED,DEPT NEUROL,MINNEAPOLIS,MN 55455
关键词
EMISSION COMPUTED TOMOGRAPHY; F-18]FLUORODEOXYGLUCOSE; BIOPSY AND BIOPSIES; CT GUIDED; BRAIN; NEOPLASMS; STEREOTAXIC;
D O I
10.1097/00004728-199109000-00013
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The CT-guided stereotaxic needle biopsy has become a widely used procedure in the diagnostic evaluation of intracranial lesions including tumors. Conventional CT or MR frequently defines the anatomic regions of abnormality, which may be multiple lesions or a single lesion that is heterogeneous in cellular composition owing to the topographic variation of cellular constituency or the combination of active disease, nonspecific inflammation, necrosis, and/or edema. In these cases, selection of the most appropriate site for a successful diagnostic needle biopsy can be difficult. In three patients, we have used [F-18]fluorodeoxyglucose (FDG) positron emission tomography (PET) to determine the site most likely to provide a diagnostic biopsy result. In the first patient, who presented with confusion, multiple biopsies from the temporal lobe, based on MR abnormalities, revealed only reactive gliosis and edema. Repeat biopsy directed by PET revealed an anaplastic astrocytoma. In a second patient, PET allowed us to differentiate radiation effect from active metastatic breast cancer. In the third patient, who presented with a grand mal seizure, biopsy of a CT-defined hypodense region demonstrated lymphocytosis. Metabolism of FDG was normal or increased in areas of Aspergillus encephalitis at autopsy. These preliminary studies suggest a complementary role for FDG-PET and CT or MR in selected patients for defining the intracranial site most likely to yield a positive biopsy result.
引用
收藏
页码:796 / 801
页数:6
相关论文
共 35 条
  • [1] DISCREPANCIES IN BRAIN-TUMOR EXTENT AS SHOWN BY COMPUTED-TOMOGRAPHY AND POSITRON EMISSION TOMOGRAPHY USING [GA-68] EDTA, [C-11] GLUCOSE, AND [C-11] METHIONINE
    BERGSTROM, M
    COLLINS, VP
    EHRIN, E
    ERICSON, K
    ERIKSSON, L
    GREITZ, T
    HALLDIN, C
    VONHOLST, H
    LANGSTROM, B
    LILJA, A
    LUNDQVIST, H
    NAGREN, K
    [J]. JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 1983, 7 (06) : 1062 - 1066
  • [2] STEREOTACTIC BIOPSIES AND COMPUTER TOMOGRAPHY IN GLIOMAS
    BOETHIUS, J
    COLLINS, VP
    EDNER, G
    LEWANDER, R
    ZAJICEK, J
    [J]. ACTA NEUROCHIRURGICA, 1978, 40 (3-4) : 223 - 232
  • [3] MAGNETIC-RESONANCE OF THE BRAIN - THE OPTIMAL SCREENING TECHNIQUE
    BRANTZAWADZKI, M
    NORMAN, D
    NEWTON, TH
    KELLY, WM
    KJOS, B
    MILLS, CM
    DILLON, W
    SOBEL, D
    CROOKS, LE
    [J]. RADIOLOGY, 1984, 152 (01) : 71 - 77
  • [4] BROWN RA, 1981, AM J NEURORADIOL, V2, P181
  • [5] THE ANATOMY OF ASTROCYTOMAS
    BURGER, PC
    [J]. MAYO CLINIC PROCEEDINGS, 1987, 62 (06) : 527 - 529
  • [6] BURGER PC, 1983, APPL NEUROPHYSIOL, V46, P180
  • [7] BURGER PC, 1989, CANCER-AM CANCER SOC, V63, P2014, DOI 10.1002/1097-0142(19890515)63:10<2014::AID-CNCR2820631025>3.0.CO
  • [8] 2-L
  • [9] ABSENCE OF CONTRAST ENHANCEMENT ON CT BRAIN-SCANS OF PATIENTS WITH SUPRATENTORIAL MALIGNANT GLIOMAS
    CHAMBERLAIN, MC
    MUROVIC, JA
    LEVIN, VA
    [J]. NEUROLOGY, 1988, 38 (09) : 1371 - 1374
  • [10] DAVIDSON HD, 1985, AM J NEURORADIOL, V6, P499