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Journal of Korean Neurosurgical Society > Volume 49(5); 2011 > Article
Journal of Korean Neurosurgical Society 2011;49(5): 278-283.
doi: https://doi.org/10.3340/jkns.2011.49.5.278
The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in the Treatment of Brain Abscess.
Seong Hyun Park, Sang Woo Lee, Dong Hun Kang, Jeong Hyun Hwang, Joo Kyung Sung, Sung Kyoo Hwang
1Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea. nsdoctor@naver.com
2Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea.
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.
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.
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.
MRI plus FDG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.
Key Words: Brain abscess; 18F-Fluorodeoxyglucose positron emission tomography; Magnetic resonance imaging; Diffusion-weighted imaging; Antibiotics
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