Fig 1.
20-year old woman with left frontal tumor with FLAIR- hyperintensity (A) and minimal contrast enhancement (B); leading to a diagnosis of an astrocytoma WHO grade III by MRI alone. In methionine-PET an intensive tracer more-uptake (T/N ratio 4.9) of this lesion is seen (C, D fused), making diagnosis of an astrocytoma WHO grade III with an oligodendroglial component more likely.
Fig 2.
71-year old female patient with left sided pre-/central FLAIR—hyperintensity (A) without contrast enhancement (B). Integrated methionine PET showed a focal pathologic tracer uptake (SUVmax 2.5 T/N, ratio 2.27) of this lesion (C, D (fusion of FLAIR and PET)). Diagnosis was an astrocytoma WHO grade II.
Table 1.
The data display diagnosis based on the reference standard for all lesions and for all high/low grade astrocytoma with structural MRI alone and with integrated 11C-methionine PET/MRI.
Fig 3.
21-year old male patient with a left sided temporomesial, blurry demarked FLAIR-hyperintens lesion (A), without contrast-enhancement (B), but with focal methionine uptake (SUVmax 1.5, T/N ratio 1.9) (C, D (PET-fusion image with FLAIR-images)). No correlate of the lesion was found in native T1w (E), SWI (F), DWI-b1000 (G) and ADC-images (H). 10 months after initial methionine PET/MRI a progress from a formerly astrocytoma °2 to a high-grade glioma was suspected and operation finally revealed a histopathologically confirmed GBM.
Table 2.
The data display diagnosis based on the reference standard for vascular, autoimmune and other lesions with structural MRI alone and with integrated 11C-methionine PET/MRI.
Fig 4.
Boxplot of low-grade and high-grade glioma.
Boxplot of the SUVmax T/N ratios of low-grade and high-grade glioma. Despite the means differed significantly both entities showed a broad overlap.
Table 3.
Resulting scores for diagnostic confidence of all lesions.
Table 4.
Resulting scores for diagnostic confidence of low-grade astrocytoma.
Table 5.
Resulting scores for diagnostic confidence of high-grade astrocytoma.