FDG-PET SCREENING FOR CEREBRAL METASTASES IN PATIENTS WITH SUSPECTED MALIGNANCY

2-F-18-Fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PE T) is increasingly being used in the evaluation of patients with malig nancy. Recently imaging protocols have incorporated 'whole-body' views acquired over multiple steps. However, with this strategy, brain meta stases can potentially go undetected. The aim of this study was to det ermine whether a supplementary 10-min brain F-18-FDG scan provides add itional clinically useful information. Accordingly, we reviewed the st udies of 273 patients with various malignancies in whom both whole-bod y and brain images were performed. Whole-body and regional attenuation -corrected F-18-FDG images were obtained similar to 60 min post-inject ion. A separate 10-min scan of the brain was subsequently performed. A ll studies were performed using a standard PET scanner with the images being interpreted by consensus of at least two experienced observers. Altogether, 119 studies were reported as normal (n = 96) or showing a natomic or normal variants (n = 23). Abnormalities involving extracran ial organs were identified in 149 (55%) patients. Cerebral metastases were reported in 4 (1.5%) patients, only two of which (0.7%) were unsu spected prior to the PET scan. Incidental pathology (encephalopathy, i nfarct) was reported but unconfirmed in two further patients (0.7%). W e conclude that routine 'screening' for cerebral metastases in patient s with suspected malignancy has a low yield and may not be clinically useful.