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01-07-2011 | Original Article

Does adding FDG-PET to MRI improve the differentiation between primary cerebral lymphoma and glioblastoma? Observer performance study

Authors: Keishi Makino, Toshinori Hirai, Hideo Nakamura, Ryuji Murakami, Mika Kitajima, Yoshinori Shigematsu, Rumi Nakashima, Shinya Shiraishi, Hiroyuki Uetani, Koya Iwashita, Masuma Akter, Yasuyuki Yamashita, Jun-ichi Kuratsu

Published in: Annals of Nuclear Medicine | Issue 6/2011

Abstract

Objective

It is sometimes difficult to distinguish between primary central nervous system lymphomas (PCNSL) and glioblastoma multiforme (GBM). The aim of this study was to investigate whether the addition of ¹⁸F-2-fluoro-2-deoxy-d-glucose positron emission tomography ([¹⁸F]FDG-PET) and apparent diffusion coefficients (ADC) to conventional MRI improves diagnostic accuracy for distinguishing between PCNSL and GBM with similar MRI findings.

Methods

We used conventional- and diffusion-weighted MRI and FDG-PET scans of 21 patients with histologically confirmed brain tumors exhibiting similar MRI findings (PCNSL, n = 14, GBM, n = 7) in our observer performance study that consisted of 3 interpretation sessions. ADC and maximum standard uptake values (SUV_max) of the tumors were calculated. Three radiologists first interpreted conventional MRI (1st session), then they read images to which the ADC value had been added (2nd session), and finally they interpreted images supplemented with SUV_max (3rd session). Observer performance was evaluated using κ statistic and receiver operating characteristics analyses.

Results

The addition of ADC values to conventional MRI failed to improve the differentiation between PCNSL and GBM. The addition of SUV_max at the third session improved the diagnostic accuracy of all 3 readers and resulted in higher interobserver agreement; mean accuracy was 95% (range 93–100%). In one observer the accuracy of tumor differentiation was significantly improved at the third compared to the second session (p = 0.017).

Conclusions

In a selected group of PCNSL and GBM with similar MRI findings, the addition of quantitative FDG-PET to MRI may improve their differentiation. ADC measurement did not allow further discrimination.

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Title: Does adding FDG-PET to MRI improve the differentiation between primary cerebral lymphoma and glioblastoma? Observer performance study
Authors: Keishi Makino
Toshinori Hirai
Hideo Nakamura
Ryuji Murakami
Mika Kitajima
Yoshinori Shigematsu
Rumi Nakashima
Shinya Shiraishi
Hiroyuki Uetani
Koya Iwashita
Masuma Akter
Yasuyuki Yamashita
Jun-ichi Kuratsu
Publication date: 01-07-2011
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 6/2011
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-011-0483-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Does adding FDG-PET to MRI improve the differentiation between primary cerebral lymphoma and glioblastoma? Observer performance study

Abstract

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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