Original ArticleUsefulness of 18F-fluorodeoxyglucose−Positron Emission Tomography in Comparison with Methionine−Positron Emission Tomography in Differentiating Solid Hemangioblastoma from Adult Cerebellar Tumors
Introduction
Primary intraaxial tumors are less common than extraaxial tumors in the adult posterior fossa. Hemangioblastoma (HB), which is the most common primary adult intraaxial posterior tumor,1 is easy to diagnose based on its typical appearance of an enhancing cystic nodule. However, solid HB is sometimes difficult to diagnose. Although conventional magnetic resonance imaging (MRI) is essential for diagnosis, it is not usually helpful in the differentiation of brain tumors. In such cases, positron emission tomography (PET) may offer useful complementary diagnostic information based on signals of tissue metabolic activity, which may differ among various tumor types. Both 18F-fluorodeoxyglucose (FDG)-PET and methionine PET are frequently used for the diagnosis of brain tumors.
To the best of our knowledge, there has only been 1 report that showed the PET findings of cerebellar HB, but this study did not assess the differentiation of HBs from other cerebellar tumors.2 The purpose of this study was to evaluate the usefulness of PET with FDG and methionine in differentiating HBs from adult primary intraaxial tumors and from a single cerebellar metastatic brain tumor (MET) in the posterior fossa.
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Patients
This study included 8 patients with intraaxial cerebellar tumors (4 HBs, 3 primary central nervous system lymphomas, and 1 glioblastoma) and 4 patients with solitary METs who were treated at the Hokuto Hospital, Obihiro, Japan, between December 2009 and October 2017. All patients gave written informed consent before the study. In all patients, pathologic diagnosis was proven by surgery after PET. FDG-PET and methionine-PET were performed on the same day or the next day before surgery. None of
Results
The PET findings are shown in Table 1. The 2 cases of HB had relatively low mean SUVmax on FDG-PET (4.3) and methionine-PET (4.0) (Figure 1). The mean FDG-PET and methionine-PET SUVmax values were 15.5 and 5.1, respectively, in 3 cases of primary central nervous system lymphoma and 14.2 and 6.3, respectively, in 1 case of glioblastoma. The mean SUVmax of FDG-PET in the 4 cases of MET was 11.6, whereas that of methionine-PET in the 3 cases of MET was 5.0 (Figure 2). In the 4 cases of HB, the
Discussion
In the present study, we used FDG-PET and methionine-PET to differentiate HB from adult cerebellar primary intraaxial tumors and a single metastatic brain tumor. Our results revealed accumulation of FDG-PET and methionine-PET in these tumors, suggesting that FDG-PET may be useful for distinguishing cerebellar HB from other tumors.
HB is classified into 2 morphologic types: cystic and solid.3 HB can be easily diagnosed by its typical MRI findings, which is an enhancing cystic nodule. Because the
Conclusions
In contrast methionine, FDG uptake in HB was lower than that of other adult intraaxial cerebellar and metastatic brain tumors, suggesting that FDG-PET may be useful for distinguishing cerebellar HB from other tumors.
References (7)
- et al.
Tryptophan metabolism in breast cancers: molecular imaging and immunohistochemistry studies
Nucl Med Biol
(2012) The rate-limiting step for tumor [18F] fluoro-2-deoxy-D-glucose (FDG) incorporation
Nucl Med Biol
(2001)- et al.
Radiologic-pathologic correlation: hemangioblastoma
AJNR Am J Neuroradiol
(1992)
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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.