The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in the Treatment of Brain Abscess.
10.3340/jkns.2011.49.5.278
- Author:
Seong Hyun PARK
1
;
Sang Woo LEE
;
Dong Hun KANG
;
Jeong Hyun HWANG
;
Joo Kyung SUNG
;
Sung Kyoo HWANG
Author Information
1. Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea. nsdoctor@naver.com
- Publication Type:Original Article
- Keywords:
Brain abscess;
18F-Fluorodeoxyglucose positron emission tomography;
Magnetic resonance imaging;
Diffusion-weighted imaging;
Antibiotics
- MeSH:
Abscess;
Anti-Bacterial Agents;
Brain;
Brain Abscess;
Craniotomy;
Electrons;
Humans;
Magnetic Resonance Imaging;
Positron-Emission Tomography;
Recurrence
- From:Journal of Korean Neurosurgical Society
2011;49(5):278-283
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study was to evaluate whether 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used to assess the therapeutic response of brain abscess. METHODS: A study was conducted on 10 consecutive patients with brain abscess. Magnetic resonance imaging (MRI) with diffuse-weighted imaging (DWI) was performed at 3 and 6 weeks after surgical treatment and intravenous antibiotics therapy and FDG-PET at 6 weeks after treatment. The extent of the abscess, signal changes on MRI, and FDG-PET standardized uptake values were analyzed and correlated with the response to therapy. RESULTS: Aspiration or craniotomy with excision of the abscess followed by intravenous antibiotics for 6-8 weeks resulted in good recovery with no recurrence. In 10 patients, two had low signal intensity on the DWI; one had no uptake on FDG-PET imaging after 6 weeks antibiotics and discontinued intravenous treatment, but the other patient had diffuse, increased uptake on FDG-PET imaging after 6 weeks antibiotics and underwent an additional 2 weeks of intravenous antibiotics. The remaining eight patients had high signals on the DWI. Four had no uptake on FDG-PET imaging and the treatment period varied from 6 to 8 weeks (mean, 6.75 weeks). Among the other four patients, FDG was accumulated in a diffuse or local area corresponding to a high signal area within the DWI and 2 weeks of intravenous antibiotics was added. CONCLUSION: MRI plus FDG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.