PET/CT to Assess Prognosis after a Brain Injury

Abstract

In a comatose patient with acute subdural haematoma, the polytrauma spiral indicated pulmonary metastasising renal carcinoma, which limited therapeutic possibilities. Whole-body positron-emission tomography/computer tomography (PET/CT) was performed with fluorodesoxyglucose. Renal carcinoma with pulmonary, nodal and parotidal metastases was proved. A cerebral metastasis could not be excluded because of perifocal hypermetabolism. There were few therapeutic possibilities. PET/CT is possible and sensible in the unconscious patient to differentiate the results of polytrauma-CT.

Key words

brain injury - coma - PET/CT - prognosis - cancer

• References/Literatur

• 1 Janssens U, Burchardi H, Duttge G. et al. Therapiezieländerung und Therapiebegrenzung in der Intensivmedizin. Positionspapier der Sektion Ethik der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI). 2012 Im Internet: https://www.divi.de/empfehlungen/publikationen/ethik/357-therapiezielaenderung-und-therapiebegrenzung/file Stand: 21.02.2018
• 2 Livingston DH, Lavery RF, Mosenthal AC. et al. Recovery at one year following isolated traumatic brain injury: a Western Trauma Association prospective multicenter trial. J Trauma 2005; 59: 1298-1304
• 3 Röhrer S, Woischneck D, Wirtz CR. et al. Epidemiological data on head trauma in Europe. Eur Orthop Traumatol 2013; 4: 41-47
• 4 Deunk J, Dekker HM, Brink M. et al. The value of indicated computed tomography scan of the chest and abdomen in addition to the conventional radiologic work-up for blunt trauma patients. J Trauma 2007; 63: 757-763
• 5 Self ML, Blake AM, Whitley M. et al. The benefit of routine thoracic, abdominal, and pelvic computed tomography to evaluate trauma patients with closed head injuries. Am J Surg 2003; 186: 609-613
• 6 Sherer M, Struchen MA, Yablon SA. Comparison of indices of traumatic brain injury severity: Glasgow Coma Scale, length of coma and post-traumatic amnesia. J Neurol Neurosurg Psychiatry 2008; 79: 678-685
• 7 Brix G, Lechel U, Glatting G. et al. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med 2005; 46: 608-613
• 8 Gofrit ON, Orevi M. Diagnostic challenges of kidney cancer: a systematic review of the role of positron emission tomography-computerized tomography. J Urol 2016; 196: 648-657
• 9 Plathow C, Walz M, Lichy MP. et al. Kostenüberlegungen zur Ganzkörper-MRT und PET-CT im Rahmen des onkologischen Stagings. Radiologe 2008; 48: 384-396
• 10 McGlone BS, Balan KK. The use of nuclear medicine techniques in the emergency department. Emerg Med J 2001; 18: 424-429