18-Fluorodeoxyglucose uptake and survival of patients with suspected recurrent malignant glioma

Cancer. 1997 Jan 1;79(1):115-26.


Background: After intensive initial radiation therapy for malignant glioma, magnetic resonance imaging (MRI) and computerized tomography (CT) cannot distinguish tumor progression from radiation injury.

Methods: The authors studied the prognostic value of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in 55 patients with malignant glioma for whom MRI obtained after initial surgery and radiation therapy demonstrated enlarging, enhancing lesions consistent with either tumor progression or radiation necrosis. Forty patients (73%) had an initial diagnosis of Grade 4 malignant glioma and 15 (27%) had Grade 3 malignant glioma. The FDG-PET scans were graded visually on a four-level scale at the time of acquisition.

Results: In univariate analysis, the FDG-PET score was a significant predictor of survival time after FDG-PET scanning (P = 0.005). Median survival was 10 months for patients with FDG-PET scores of 2 or 3 (glucose uptake > or = adjacent cortex) and 20 months for those with scores of 0 or 1 (glucose uptake < adjacent cortex). In multivariate proportional hazards analysis, the FDG-PET score was a significant predictor of survival (P = 0.019) in a model that included patient age, recurrence number, and FDG-PET score. There was no significant difference in the FDG-PET score hazard ratio for patients with Grade 3 or 4 tumors at initial diagnosis, first or later suspected recurrence, initial photon irradiation given with standard fractions or hyperfractionation, or stereotactic irradiation prior to FDG-PET scanning.

Conclusions: This analysis demonstrates that FDG-PET scanning has prognostic value in a cohort limited to patients with suspected recurrent high grade glioma.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Astrocytoma / diagnostic imaging
  • Astrocytoma / metabolism
  • Astrocytoma / mortality
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / mortality
  • Child
  • Deoxyglucose / analogs & derivatives*
  • Deoxyglucose / pharmacokinetics
  • Female
  • Fluorine Radioisotopes* / pharmacokinetics
  • Fluorodeoxyglucose F18
  • Glioma / diagnostic imaging*
  • Glioma / metabolism
  • Glioma / mortality
  • Humans
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Survival Analysis


  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Deoxyglucose