[en] 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) PET remains widely used in neuro-oncology and provides valuable metabolic information in both adult and pediatric brain tumors. In primary central nervous system lymphomas, it plays an important role in diagnosis, staging, prognostic assessment, and treatment monitoring. In gliomas and other brain tumors, because of the high physiologic uptake in normal brain tissue, particularly in the cortex, tumor-to-background contrast may be reduced. Nevertheless, 18F FDG PET can help to characterize tumor aggressiveness, guide biopsy, and detect residual or recurrent disease.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Steenhout, Camille ; Centre Hospitalier Universitaire de Liège - CHU > > Service médical de médecine nucléaire et imagerie onco
Hustinx, Roland ; Université de Liège - ULiège > Département des sciences cliniques > Médecine nucléaire
Newberg, Andrew B; Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA, Department of Integrative Medicine and Nutritional Sciences, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
Alavi, Abass; Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Withofs, Nadia ; Université de Liège - ULiège > GIGA > GIGA Platforms - In Vivo Imaging - Nuclear Medicine Division
Language :
English
Title :
2-[18F]fluoro-2-deoxy-d-glucose PET in Brain Tumors.
McNeill KA. Epidemiology of brain tumors. Neurol Clin. 2016;34(4):981-998.
Ostrom QT, Cioffi G, Gittleman H, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012-2016. Neuro-Oncol. 2019;21(Supplement_5):v1-v100.
Ostrom QT, Wright CH, Barnholtz-Sloan JS. Brain metastases: epidemiology. In: Handbook of Clinical Neurology. Vol 149. Elsevier; 2018:27-42.
Weller M, Van Den Bent M, Preusser M, et al. EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood. Nat Rev Clin Oncol. 2021;18(3):170-186.
Verger A, Kas A, Darcourt J, Guedj E. PET imaging in neuro-oncology: an update and overview of a rapidly growing area. Cancers. 2022;14(5):1103.
Chen W, Silverman DHS. Advances in evaluation of primary brain tumors. Semin Nucl Med. 2008;38(4):240-250.
Lewis DY, Soloviev D, Brindle KM. Imaging tumor metabolism using positron emission tomography. Cancer J. 2015;21(2):129-136.
Mair MJ, Lohmann P, Galldiks N, et al. Availability and use of PET in patients with brain tumours - a European Organisation for Research and Treatment of Cancer - Brain Tumour Group (EORTC-BTG) survey. Eur J Nucl Med Mol Imaging. 2025;52(12):4627-4638.
Galldiks N, Tonn JC, Preusser M, Albert NL. Update to the RANO Working Group and EANO recommendations for the clinical use of PET imaging in gliomas. Neuro-Oncol. 2025;27(10):2492-2493.
Zhang J, Traylor KS, Mountz JM. PET and SPECT imaging of brain tumors. Semin Ultrasound CT MRI. 2020;41(6):530-540.
Warburg O. On the origin of cancer cells. Science. 1956:309-314.
Kilbourn MR. Small Molecule PET tracers for transporter imaging. Semin Nucl Med. 2017;47(5):536-552.
Horowitz T, Tabouret E, Graillon T, et al. Contribution of nuclear medicine to the diagnosis and management of primary brain tumours. Rev Neurol (Paris). 2023;179(5):394-404.
Arbizu J, Morbelli S, Minoshima S, et al. SNMMI Procedure Standard/EANM Practice Guideline for Brain [18F]FDG PET Imaging, Version 2.0. J Nucl Med. 2025;66(Supplement 2):S45-S60.
Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro-Oncol. 2021;23(8):1231-1251.
Dunet V, Pomoni A, Hottinger A, Nicod-Lalonde M, Prior JO. Performance of 18F-FET versus 18F-FDG-PET for the diagnosis and grading of brain tumors: systematic review and meta-analysis. Neuro-Oncol. 2016;18(3):426-434.
Albert NL, Weller M, Suchorska B, et al. Response Assessment in Neuro-Oncology working group and European Association for Neuro-Oncology recommendations for the clinical use of PET imaging in gliomas. Neuro-Oncol. 2016;18(9):1199-1208.
Colavolpe C, Metellus P, Mancini J, et al. Independent prognostic value of pre-treatment 18-FDG-PET in high-grade gliomas. J Neurooncol. 2012;107(3):527-535.
Withofs N, Kumar R, Alavi A, Hustinx R. Facts and Fictions About [18F]FDG versus Other Tracers in Managing Patients with Brain Tumors. PET Clin. 2022;17(3):327-342.
Delbeke D, Meyerowitz C, Lapidus RL, et al. Optimal Cutoff Levels of F-18 fluorodeoxyglucose uptake in the differentiation of low-grade from high-grade brain tumors with PET. Radiology. 1995;195(1):47-52.
Takahashi M, Soma T, Mukasa A, Tanaka S, Yanagisawa S, Momose T. Pattern of FDG and MET Distribution in High- and Low-Grade Gliomas on PET Images. Clin Nucl Med. 2019;44(4):265-271.
Ozutemiz C, Neil EC, Tanwar M, Rubin NT, Ozturk K, Cayci Z. The Role of Dual-Phase FDG PET/CT in the diagnosis and follow-up of brain tumors. Am J Roentgenol. 2020;215(4):985-996.
Galldiks N, Lohmann P, Aboian M, et al. Update to the RANO working group and EANO recommendations for the clinical use of PET imaging in gliomas. Lancet Oncol. 2025;26(8):e436-e447.
Okada H, Weller M, Huang R, et al. Immunotherapy response assessment in neuro-oncology: a report of the RANO working group. Lancet Oncol. 2015;16(15):e534-e542.
Galldiks N, Langen KJ, Albert NL, et al. PET imaging in patients with brain metastasis-report of the RANO/PET group. Neuro-Oncol. 2019;21(5):585-595.
Verger A, Tolboom N, Cicone F, et al. Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0. Eur J Nucl Med Mol Imaging. 2025;52(5):1822-1839.
Horky LL, Hsiao EM, Weiss SE, Drappatz J, Gerbaudo VH. Dual phase FDG-PET imaging of brain metastases provides superior assessment of recurrence versus post-treatment necrosis. J Neurooncol. 2011;103(1):137-146.
Liu Y, Ding H, Cao J, Liu G, Chen Y, Huang Z. [68Ga]Ga-FAPI PET/CT in brain tumors: comparison with [18F]F-FDG PET/CT. Front Oncol. 2024;14:1436009.
Sadeghpour S, Aghaee A, Ahmadzadehfar H, Rizzo A, Treglia G, Sadeghi R. Revealing the hidden: A systematic review and meta-analysis of FAPI-based tracers imaging for brain metastatic lesions. Eur J Nucl Med Mol Imaging. 2026;53(3):1419-1433.
Chen H, Pang Y, Wu J, et al. Comparison of [68Ga]Ga-DOTA-FAPI-04 and [18F] FDG PET/CT for the diagnosis of primary and metastatic lesions in patients with various types of cancer. Eur J Nucl Med Mol Imaging. 2020;47(8):1820-1832.
Lauw MIS, Lucas CHG, Ohgami RS, Wen KW. Primary central nervous system lymphomas: a diagnostic overview of key histomorphologic, immunophenotypic, and genetic features. Diagnostics. 2020;10(12):1076.
Rozenblum L, Houillier C, Baptiste A, et al. Interim FDG-PET improves treatment failure prediction in primary central nervous system lymphoma: An LOC network prospective multicentric study. Neuro-Oncol. 2024;26(7):1292-1301.
Rozenblum L, Houillier C, Soussain C, et al. Role of Positron Emission Tomography in Primary Central Nervous System Lymphoma. Cancers. 2022;14(17):4071.
Verger A, Couturier O. Role de la TEP en neuro-oncologie : apport des traceurs FDG, aux acides amines et des recepteurs de la somatostatine dans la prise en charge des tumeurs cerebrales. Medecine Nucl. 2025;49(6):325-329.
Rozenblum L, Galanaud D, Houillier C, et al. [18F]FDG PET-MRI provides survival biomarkers in primary central nervous system lymphoma in the elderly: an ancillary study from the BLOCAGE trial of the LOC network. Eur J Nucl Med Mol Imaging. 2023;50(12):3684-3696.
Barajas RF, Politi LS, Anzalone N, et al. Consensus recommendations for MRI and PET imaging of primary central nervous system lymphoma: guideline statement from the International Primary CNS Lymphoma Collaborative Group (IPCG). Neuro-Oncol. 2021;23(7):1056-1071.
Rachdi A, Hernandez-Tost H, Herzi D, et al. Recent advances in the diagnosis and the treatment of primary CNS lymphoma. Rev Neurol (Paris). 2023;179(5):481-489.
Verger A, Albert NL, Brendel M, et al. EANM insights on PET-based response assessment in neuro-oncology: things are moving forward! EANM J. 2025;1:100008.
Yarabarla V, Mylarapu A, Han TJ, McGovern SL, Raza SM, Beckham TH. Intracranial meningiomas: an update of the 2021 World Health Organization classifications and review of management with a focus on radiation therapy. Front Oncol. 2023;13:1137849.
Galldiks N, Albert NL, Sommerauer M, et al. PET imaging in patients with meningioma-report of the RANO/PET Group. Neuro-Oncol. 2017;19(12):1576-1587.
Dutour A, Kumar U, Panetta R, et al. Expression of somatostatin receptor subtypes in human brain tumors. Int J Cancer. 1998;76(5):620-627.
Albert NL, Preusser M, Traub-Weidinger T, et al. Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor ligands: version 1.0. Eur J Nucl Med Mol Imaging. 2024;51(12):3662-3679.
Galldiks N, Lohmann P, Albert NL, Tonn JC, Langen KJ. Current status of PET imaging in neuro-oncology. Neuro-Oncol Adv. 2019;1(1):vdz010.
Uslu L, Donig J, Link M, Rosenberg J, Quon A, Daldrup-Link HE. Value of 18F-FDG PET and PET/CT for Evaluation of Pediatric Malignancies. J Nucl Med. 2015;56(2):274-286.
d’Amati A, Bargiacchi L, Rossi S, et al. Pediatric CNS tumors and 2021 WHO classification: what do oncologists need from pathologists? Front Mol Neurosci. 2024;17:1268038.
Piccardo A, Albert NL, Borgwardt L, et al. Joint EANM/SIOPE/RAPNO practice guidelines/SNMMI procedure standards for imaging of paediatric gliomas using PET with radiolabelled amino acids and [18F]FDG: version 1.0. Eur J Nucl Med Mol Imaging. 2022;49(11):3852-3869.
Stanescu L, Ishak GE, Khanna PC, Biyyam DR, Shaw DW, Parisi MT. FDG PET of the Brain in Pediatric Patients: Imaging Spectrum with MR Imaging Correlation. RadioGraphics. 2013;33(5):1279-1303.
Patil S, Biassoni L, Borgwardt L. Nuclear Medicine in Pediatric Neurology and Neurosurgery: Epilepsy and Brain Tumors. Semin Nucl Med. 2007;37(5):357-381.
Sager G, Akgun E, Abuqbeitah M, et al. Comparison of brain F-18 FDG PET/MRI with PET/CT imaging in pediatric patients. Clin Neurol Neurosurg. 2021;206:106669.
Aboian MS, ReisTeixeira S, Zhuang H, States LJ. Management of Pediatric Brain Tumors with the Aid of PET/MR Imaging. PET Clin. 2026;21(2):229-243.
Antonevskaya TL, Yadgarov MYa, Likar YuN. Diagnostic and prognostic value of [18F] FET PET imaging in pediatric and adolescent brain tumors: a systematic review and meta-analysis. Clin Transl Imaging. 2025;13(3):283-301.
Safarian A, Mirshahvalad SA, Farbod A, et al. Artificial Intelligence for Tumor [18F]FDG PET Imaging: Advancements and Future Trends - Part II. Semin Nucl Med. 2025;55(5):856-868.