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Neurosciences: NeurologyNeurology Posters |
1 Institute of Neuroscience and Biophysics - Medicine; 2 Institute of Neuroscience and Biophysics - Nuclear Chemistry, Research Center Jülich, Jülich, Germany; 3 Department of Neurosurgery, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
958
Objectives: Nonspecific incidental brain lesions (NIL) are more frequently detected due to an increasing number of screening or research MR-scans of the brain and their natural course is uncertain.
Methods: In a prospective study we determined the outcome of patients with incidental, non-enhancing brain lesions depending on findings of MRI and PET using F-18-fluoroethyl-L-tyrosine (FET). Patients with clinical symptoms or previous brain disease were excluded. 21 patients were eligible. Follow-up ranged from 3 to 8.5 years. Mean lesion to brain ratios (L/B) > 1.6 in FET PET were rated as positive.
Results: Four different outcome groups were identified: (A) Five NIL regressed or vanished completely. The lesions were circumscribed in MRI and FET-uptake was negative (L/B of 1.2 ± 0.2). (B) Ten NIL were stable. The lesions were circumscribed in MRI and FET-uptake was negative (L/B: 1.0 ± 0.1). (C) Two NIL grew slowly over years and an astrocytoma WHO grade II was diagnosed. The lesions were circumscribed in MRI and FET-uptake was negative (L/B: 0.7 and 1.0). (D) Four NIL showed sudden and rapid growth and a high grade glioma was diagnosed. The lesions were diffuse in MRI and FET-uptake was significantly increased (L/B: 2.0 ± 0.4, p < 0.01 versus group A and B).
Conclusions: In NIL a circumscribed pattern in MRI and a normal to low FET-uptake in PET are strong predictors for a benign course with eventual development of a low grade glioma. In contrast, NIL with a diffuse pattern in MRI and an increased FET-uptake indicate a high risk for a high grade glioma.
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