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Evaluating Brain Lesions: Adding Eyes to Thighs Protocol of Imaging for 18FDG-PET

Rifaat Hussain

Practices guidelines for PET-CT (positron emission tomography with computed tomography) imaging for oncology dictates acquiring images from the base of the skull to mid-thigh (eye to thigh protocol), excluding imaging the brain. The accepted reason being given that brain, because of its high metabolism and exclusive glucose use, will “hide” lesions. Other positron emitting radionuclides have been rightly developed for its imaging, mainly Carbon -11 methionine, fluorine-18 fluoroethyltyrosine (18F-FET), fluorine-18 dihydroxyphenylalanine (18F-FDOPA). The authors however argue that including the brain in the imaging protocol adds no extra radiation burden to the patient and adds on only a little on the acquisition time, however the benefit yield can add acknowledged benefits and sometimes change management paradigms.