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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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The importance of PET-CT in neurosurgical diagnostics and decision-making

Meeting Abstract

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  • Almut Pöllmann - Klinik für Neurochirurgie, Vivantes Klinikum im Friedrichshain, Berlin
  • Michail Plotkin - Klinik für Nuklearmedizin, Vivantes Klinikum im Friedrichshain, Berlin
  • Dag Moskopp - Klinik für Neurochirurgie, Vivantes Klinikum im Friedrichshain, Berlin

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 189

doi: 10.3205/14dgnc583, urn:nbn:de:0183-14dgnc5836

Published: May 13, 2014

© 2014 Pöllmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: In recent years the PET-CT has gained considerable importance in diagnostics and decision-making concerning neurosurgical treatment. It will be shown, in which neurosurgical diseases PET-CT can be used as a diagnostic tool, where it provides important additional information complementary to other imaging techniques and how patients can benefit from it.

Method: All PET-CTs performed within 2 years in our clinic were examined retrospectively. 161 PET-CTs (F18-FET, F18-FDG, Ga68-DOTATATE and F18-DOPA) were performed in 118 patients.

Results: 82 F18-FET-PET were performed in patients with cerebral tumors and served mainly as preoperative detection of “hot spots” for biopsy planning in patients with glioma and for follow-up in order to distinguish changes in MRI of postoperative or radiation-induced changes. In addition, an increasing malignancy of former low-grade glioma could be detected. Thus, the F18-FET-PET helped in the planning of surgery and in decision-making for secondary surgery. False-positive results were found in 3 cases. 60 F18-FDG-PET were performed; 35 in patients with suspected metastasis in order to detect the primary tumor and for staging. 11 were used to search for an inflammatory focus as well as to detect suspected spondylodiscitis. This detected a spondylodiscitis reliably, a primary focus of inflammation was detected in only one case. 14 FDG-PET were performed in patients with neurofibromatosis type 1 and in patients with MPNST in order to distinguish between malignant and benign tumors and to support a surgical indication. A MPNST was detected in 10 studies. One examination showed a false-positive result. 8 Ga68-DOTATATE-PET were performed, 4 of them for the diagnosis of suspected meningioma, 4 in patients with recurrent Cushing's disease. In the Cushing's patients an ectopic somatostatin-receptor-positive tumor was detected in one case. 11 F18-DOPA-PET were performed to assess the metabolic activity of the tumors in hereditary paraganglioma-pheochromocytoma syndrome.

Conclusions: The PET-CT has many applications in the diagnostics of neurosurgical diseases. It may help to substantiate an indication for surgery, to justify waiting and observing and to specify surgical planning in many cases.