正电子发射断层扫描（PET）是一种强大的工具，可以帮助医师在诊断和随访期间管理原发性脑肿瘤。在该领域中，PET成像使用三种主要的放射性示踪剂：18F-FDG、氨基酸示踪剂和68Ga偶联到生长抑素受体配体（SSTRs）上。在初步诊断时，18F-FDG有助于表征原发性中枢神经系统（PCNS）淋巴瘤和高级别胶质瘤，氨基酸示踪剂适用于胶质瘤，SSTR PET配体适用于脑膜瘤。这些示踪剂提供肿瘤等级或类型的信息，协助指导活检并帮助制定治疗计划。随访期间，在出现症状和/或磁共振成像变化的情况下，肿瘤复发和治疗后变化（特别是放射性坏死）之间的鉴别诊断可能具有挑战性，因此有强烈的兴趣使用PET评估治疗毒性。 PET还可以有助于识别特定的并发症，例如放射治疗脑病、与PCNS淋巴瘤相关的脑炎，以及与胶质瘤复发和颞叶癫痫相关的类似中风的偏头痛综合征（SMART），这些在本综述中首次进行了阐述。本综述总结了PET在脑肿瘤（特别是胶质瘤、脑膜瘤和原发性中枢神经系统淋巴瘤）的诊断、管理和随访中的主要贡献。版权所有©2023 Elsevier Masson SAS。保留所有权利。

Positron emission tomography (PET) is a powerful tool that can help physicians manage primary brain tumours at diagnosis and follow-up. In this context, PET imaging is used with three main types of radiotracers: 18F-FDG, amino acid radiotracers, and 68Ga conjugated to somatostatin receptor ligands (SSTRs). At initial diagnosis, 18F-FDG helps to characterize primary central nervous system (PCNS) lymphomas and high-grade gliomas, amino acid radiotracers are indicated for gliomas, and SSTR PET ligands are indicated for meningiomas. Such radiotracers provide information on tumour grade or type, assist in directing biopsies and help with treatment planning. During follow-up, in the presence of symptoms and/or MRI modifications, the differential diagnosis between tumour recurrence and post-therapeutic changes, in particular radiation necrosis, may be challenging, and there is strong interest in using PET to evaluate therapeutic toxicity. PET may also contribute to identifying specific complications, such as postradiation therapy encephalopathy, encephalitis associated with PCNS lymphoma, and stroke-like migraine after radiation therapy (SMART) syndrome associated with glioma recurrence and temporal epilepsy, originally illustrated in this review. This review summarizes the main contribution of PET to the diagnosis, management, and follow-up of brain tumours, specifically gliomas, meningiomas, and primary central nervous system lymphomas.Copyright © 2023 Elsevier Masson SAS. All rights reserved.