Abstract

Positron emission tomography/magnetic resonance (PET/MR) imaging systems enable a multiparametric imaging approach in neuro-oncology by combining anatomical and functional information from standard and advanced MR sequences with the metabolic and molecular data provided by PET imaging in a single session. Although conventional MR imaging is considered the standard imaging modality in neuro-oncology, it has diagnostic limitations in the evaluation of brain tumors. The combination of PET and MR in PET/MR imaging has the potential to further enhance diagnostic accuracy in neuro-oncological imaging. The most common primary malignant central nervous system pathologies are gliomas in both children and adults. In neuro-oncology, PET/MR imaging, particularly with F-18 fluorodeoxyglucose and amino acid-labeled PET radiopharmaceuticals, can be used for primary diagnosis, tumor grading and biopsy site planning, assessing tumor extent, and differentiating treatment-related changes from recurrent disease. Studies have generally shown that the combined use of parameters obtained from PET and MR enhances diagnostic performance in these indications. The aim of this review is to explain the advantages and limitations of PET/MR imaging in neuro-oncology, particularly in gliomas, as well as the fundamentals of PET and MR components, and the clinical role of hybrid PET/MR.