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Purpose

The objective was to compare 18 F-fluorodeoxyglucose (FDG) and 18 F-fluorothymidine (FLT) PET in differentiating radiation necrosis from recurrent glioma.

Materials and Methods

Visual and quantitative analyses were derived from static FDG PET and static and dynamic FLT PET in 15 patients with suspected recurrence of treated grade 2 glioma or worse with a new focus of Gd contrast enhancement on MRI. For FDG PET, SUV max and the ratio of lesion SUV max to the SUV mean of contralateral white matter were measured. For FLT PET, SUV max and Patlak-derived metabolic flux parameter Ki max were measured for the same locus. A 5-point visual confidence scale was applied to FDG PET and FLT PET. Receiver operating curve analysis was applied to visual and quantitative results. Differences between recurrent tumor and radiation necrosis were tested by Kruskal-Wallis analysis. On the basis of …