In the last decades, 18F-FDG PET imaging has been extensively used to study glucose brain metabolism . Glucose uptake distribution in the brain is mainly driven by basal neuronal activity and represents general neuronal integrity [2, 3]. The highest values of glucose consumption are found in the basal ganglia, the thalami, and the occipital polar and mesial cortex, while the medial temporal cortex and the cerebellum have the lowest values. Physiologic glucose demand is very high in brain tissue in normal condition . Due to the high physiological uptake in normal brain gray matter and variable uptake by inflammatory lesions it has thus a limited role in oncology. It can be used in selected cases to distinguish tumor recurrence from radiation necrosis in enhancing brain lesions or to distinguish gliomas from CNS lymphoma or opportunistic infections .
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