J Korean Neurosurg Soc.  2011 May;49(5):278-283. 10.3340/jkns.2011.49.5.278.

The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in the Treatment of Brain Abscess

• Park SH
• Lee SW
• Kang DH
• Hwang JH
• Sung JK
• Hwang SK

• KMID: 1442578
• DOI: http://doi.org/10.3340/jkns.2011.49.5.278

Abstract

OBJECTIVE
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.
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 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.
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 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.
CONCLUSION
MRI plus FDG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.

Keyword

Brain abscess; 18F-Fluorodeoxyglucose positron emission tomography; Magnetic resonance imaging; Diffusion-weighted imaging; Antibiotics

MeSH Terms

Abscess
Anti-Bacterial Agents
Brain
Brain Abscess
Craniotomy
Electrons
Humans
Magnetic Resonance Imaging
Positron-Emission Tomography
Recurrence
Anti-Bacterial Agents