Positron emission tomography imaging of brain tumors

This article reviews positron emission tomography (PET) imaging of gliomas, both high- and low-grade, with emphasis on the use of [F-18]fluordeoxyglucose (FDG) for assessing energy metabolism. The authors' perspective on the clinical usefulness of FDG PET in neuro-oncology is interwoven with experience from many other contributors to this field. Additional advances beyond FDG PET are exciting and potentially applicable to the management of gliomas. Biosynthesis in tumors occurs along several important broad fronts for DNA, proteins, and membrane lipids and molecular imaging of these pathways is coming to the foreground. Hypoxia, a significant resistance mechanism that compromises the efficacy of radiotherapy and chemotherapy, can now be regionally quantified in vivo with PET. In the near future, it is likely that the presence of mutant receptors, apoptosis, and angiogenesis will be measurable with PET and new tracers.