41 year old male with right frontotemporal Gr III oligo-astrocytoma. Re-radiated after 8 years for recurrence, now evaluated for persisting enhancing lesion.
Axial T1W post-contrast image (A) shows enhancing lesion along the margins of operated bed with free-hand ROI drawn defining the enhancing component copy-pasted on FDG-PET Image (B) PET/MRI fused image ( C), CBV map ( D) ADC Map ( E) to derive SUVmax, SUVmean, CBVmean & ADCmean respectively showing no focal increased FDG uptake, CBV and diffusion restriction in ADC map. Multi-voxel 1H-MRS (F) along the enhancing margin (with no significant focal FDG uptake showing no increased Cho/Cr ratio suggesting radiation necrosis.
Note: Simultaneous acquisition of multiple parameters in a single study facilitates the placement of ROI on the CEMR images to be overlaid on the PET and other MR images which ensures accurate spatial localization for quantitative evaluation of all parameters.
This short PET-MRI Scan case was compiled by Dr. Sangeeta Taneja and Dr. Amarnath Jena (Nuclear Medicine Physician at PET-Suite @ Indraprastha Apollo Hospital, Sarita Vihar).
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The Simultaneous PET-MRI Scan is currently offered at PET-Suite at Apollo Hospital, Sarita Vihar.