Fdg-pet in the selection of brain lesions for biopsy

Michael W. Hanson, Michael J. Glantz, John M. Hoffman, Allan H. Friedman, Peter C. Burger, S. Clifford Schold, R. Edward Coleman

Research output: Contribution to journalArticle

Abstract

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 [18F]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.

Original languageEnglish (US)
Pages (from-to)796-801
Number of pages6
JournalJournal of computer assisted tomography
Volume15
Issue number5
DOIs
StatePublished - Sep 1991

Keywords

  • Biopsy and biopsies
  • Biopsy and biopsies
  • Brain
  • CT guided
  • Emission computed tomography
  • Neoplasms
  • Stereotaxic
  • [F]Fluorodeoxyglucose

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Hanson, M. W., Glantz, M. J., Hoffman, J. M., Friedman, A. H., Burger, P. C., Schold, S. C., & Coleman, R. E. (1991). Fdg-pet in the selection of brain lesions for biopsy. Journal of computer assisted tomography, 15(5), 796-801. https://doi.org/10.1097/00004728-199109000-00013