PET in brain tumors

Purpose The aim of this Pictorial Essay is to illustrate the metabolic aspect of PET (positron emission tomography) imaging in relation to conventional and advanced MR (magnetic resonance) of brain neoplasms.Materials 10 patients, who performed PET-CT with amino acid tracers and/or FDG were selected from a series of more than 250 cases from a single institution. The selection was made to illustrate and discuss each of the indications reported in the European guidelines. Fusion imaging was obtained merging PET-CT with MR T1-CE (contrast enhanced) and/or T2/FLAIR sequences. The SUVmax of the lesion and the SUVmax lesion to SUVmax background ratio were evaluated. The lesion uptake was also assessed using a five-point visual scale with a range from -2 to+2 in relation to basal ganglia uptake. The Hospital Information System (HIS) and the proton therapy data archives have been used for clinical history. For each case, the critical issues were described and the physiopathological correlations were provided to explain the imaging findings.Conclusions The complexity of illustrated cases demonstrates the need for a multidisciplinary board evaluation to reach a more accurate diagnosis.