Primary malignant brain tumors are heterogeneous and infrequent neoplasms. Their classification,
therapeutic regimen and prognosis have undergone significant development requiring
the innovation of an imaging diagnostic. The performance of enhanced magnetic resonance
imaging depends on blood–brain barrier function. Several studies have demonstrated
the advantages of static and dynamic amino acid PET/CT providing accurate metabolic
status in the neurooncological setting. The aim of our single-center retrospective
study was to test the primary diagnostic role of amino acid PET/CT compared to enhanced
MRI. Emphasis was placed on cases prior to intervention, therefore, a certain natural
bias was inevitable. In our analysis for newly found brain tumors 18F-FET PET/CT outperformed
contrast MRI and PWI in terms of sensitivity and negative predictive value (100% vs.
52.9% and 36.36%; 100% vs. 38.46% and 41.67%), in terms of positive predictive value
their performance was roughly the same (84.21 % vs. 90% and 100%), whereas regarding
specificity contrast MRI and PWI were superior (40% vs. 83.33% and 100%). Based on
these results the superiority of 18F-FET PET/CT seems to present incremental value
during the initial diagnosis. In the case of non-enhancing tumors, it should always
be suggested as a therapy-determining test.
