Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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The Role of $^{18}F$-Fluorodeoxyglucose Positron Emission Tomography in the Treatment of Brain Abscess

  • Park, Seong-Hyun (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Lee, Sang-Woo (Department of Nuclear Medicine, Kyungpook National University Hospital) ;
  • Kang, Dong-Hun (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Hwang, Jeong-Hyun (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Sung, Joo-Kyung (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Hwang, Sung-Kyoo (Department of Neurosurgery, Kyungpook National University Hospital)
  • Received : 2010.08.06
  • Accepted : 2011.04.05
  • Published : 2011.05.28
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Abstract

Objective : The purpose of this study was to evaluate whether $^{18}F$-fluorodeoxyglucose positron emission tomography (FOG-PET) can be used to assess the therapeutic response of brain abscess. Methods : 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 FOG-PET at 6 weeks after treatment. The extent of the abscess, signal changes on MRI, and FOG-PET standardized uptake values were analyzed and correlated with the response to therapy. Results : 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 FOG-PET imaging after 6 weeks antibiotics and discontinued intravenous treatment, but the other patient had diffuse, increased uptake on FOG-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 FOG-PET imaging and the treatment period varied from 6 to 8 weeks (mean, 6.75 weeks). Among the other four patients, FOG 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. Conclusion : MRI plus FOG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.

Keywords

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