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BioMed Research International
Volume 2013 (2013), Article ID 247152, 8 pages
http://dx.doi.org/10.1155/2013/247152
Review Article

18F-FDG PET in the Diagnosis and Treatment of Primary Central Nervous System Lymphoma

1Department of Neurological Surgery, Faculty of Medicine, Kagawa University, 1750-1 Miki-cho, Kita-gun, Kagawa 761-0793, Japan
2Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Miki-cho, Kita-gun, Kagawa 761-0793, Japan

Received 13 March 2013; Accepted 2 June 2013

Academic Editor: Eng-Yen Huang

Copyright © 2013 Nobuyuki Kawai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This paper summarizes the usefulness and limitation of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) in the diagnosis and treatment of primary central nervous system lymphoma (PCNSL). The 18F-FDG uptake in typical PCNSL is about 2.5 times higher than that in the normal gray matter, and the tumor can usually be identified visually. The 18F-FDG uptake pattern and value provide useful information for differentiating PCNSL from other enhancing malignant brain tumors especially glioblastoma (GB). The 18F-FDG uptake in typical PCNSL is usually homogenous, and the uptake value is significantly higher than that in GB. However, 18F-FDG PET often fails to show the presence of tumor in the brain as 18F-FDG uptake is faint in atypical PCNSL such as disseminated or nonenhancing lesions. 18F-FDG PET is also useful for evaluating the treatment response at a very early stage after the initial treatment. Pretreatment and posttreatment 18F-FDG uptake values may have a prognostic value in patients with PCNSL. In conclusion, 18F-FDG PET is very useful in the diagnosis of typical PCNSL and can differentiate PCNSL from other malignant brain tumors. However, the usefulness of 18F-FDG PET is limited in the diagnosis of atypical PCNSL.