Relative value of magnetic resonance spectroscopy, magnetic resonance perfusion, and 2-(18F) fluoro-2-deoxy-D-glucose positron emission tomography for detection of recurrence or grade increase in gliomas

J Clin Neurosci. 2010 Jan;17(1):50-3. doi: 10.1016/j.jocn.2009.02.035. Epub 2009 Dec 2.


In a consecutive series of 26 previously operated patients diagnosed with cerebral glioma, magnetic resonance spectroscopy (MRS), 2-((18)F) fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and perfusion MRI (MRP), were performed at follow-up to distinguish recurrence from radiation necrosis, and to identify tumour upgrading. Discrepancy between techniques was observed in 9 cases. The positive predictive value (PPV) and the negative predictive value (NPV) of each technique to detect the presence of high grade glioma was: MRI, PPV=50%; MRS, PPV=91.6%, NPV=100%; FDG-PET, PPV=75%, NPV=61.1%; MRP, PPV=100%, NPV=100%. In the selected group of nine cases studied to differentiate viable tumour from radiation necrosis, MRS and MRP reached a PPV and a NPV of 100%, whereas for FDG-PET, PPV and NPV were 66.6% and 60%, respectively. To distinguish between viable high-grade glioma and radiation necrosis, gadolinium-enhanced MRI gives a high false-positive rate, while MRS and MRP are superior to FDG-PET in discriminating tumour recurrence, grade increase and radiation necrosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain / physiopathology
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / physiopathology
  • Diagnosis, Differential
  • Disease Progression
  • False Positive Reactions
  • Female
  • Fluorodeoxyglucose F18
  • Gadolinium
  • Glioma / diagnostic imaging
  • Glioma / pathology*
  • Glioma / physiopathology
  • Humans
  • Magnetic Resonance Angiography / methods
  • Magnetic Resonance Angiography / statistics & numerical data*
  • Magnetic Resonance Spectroscopy / methods
  • Magnetic Resonance Spectroscopy / statistics & numerical data*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / diagnostic imaging
  • Neoplasm Invasiveness / pathology
  • Neoplasm Invasiveness / physiopathology
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / physiopathology
  • Positron-Emission Tomography / methods
  • Positron-Emission Tomography / statistics & numerical data*
  • Predictive Value of Tests
  • Radiotherapy / adverse effects
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity


  • Fluorodeoxyglucose F18
  • Gadolinium