Clinical practice guideline for integrated PET/MRI in brain gliomas(2026 edition)

To further standardize the clinical application of integrated PET/MRI brain imaging for brain gliomas in China, improve the level of precision diagnosis and management, promote standardized care, and provide evidence-based and consensus recommendations for imaging professionals and clinicians, this guideline was jointly developed by the Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine, the Beijing Society of Nuclear Medicine, and the Beijing Society of Radiology, with the participation of multidisciplinary experts from nuclear medicine, radiology, neurosurgery, neuro-oncology, and radiation oncology, through multiple rounds of consensus meetings. Brain gliomas are among the most common primary brain tumors of the central nervous system, encompassing a wide spectrum of tumor grades and diverse biological behaviors. Key aspects of their clinical management include accurate diagnosis and grading, tumor extent delineation, preoperative evaluation and radiation therapy target planning, as well as differentiation between post-treatment recurrence and treatment-related changes. Integrated PET/MRI enables simultaneous acquisition of PET molecular metabolic information and multiparametric MRI structural and functional information within a single examination, effectively facilitating the above processes and serving as an important imaging modality for the precise diagnosis and treatment of brain gliomas. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges in appropriate indication selection, standardization of imaging workflows and parameter settings, image post-processing and assessment, consistency of image interpretation, and reporting. Grounded in the current accessibility of integrated PET/MRI equipment and tracers in China and in the latest domestic and international evidence-based research, and closely aligned with the realities of Chinese clinical practice, this guideline provides recommendations across key domains-clinical indications, examination and quality-control workflows, image interpretation, and standardized reporting-with the aim of offering systematic and practical evidence-based guidance for imaging specialists and clinicians involved in glioma care.

为进一步规范我国脑胶质瘤一体化PET/MRI脑成像的临床应用，提高脑胶质瘤的精准诊疗水平、促进规范化管理并为影像相关专业人员与临床医师提供循证与共识建议，由中国医学影像技术研究会、中华医学会放射学分会、中华医学会核医学分会、北京医学会核医学分会、北京医学会放射学分会联合组织，集结核医学科、放射科、神经外科、神经肿瘤科、放射肿瘤科等多学科专家，经多轮共识会议制订了本指南。脑胶质瘤是中枢神经系统最常见的原发性脑肿瘤之一，肿瘤分级跨度广、生物学行为各异。其临床管理的关键在于精准诊断与分级、肿瘤范围界定、术前评估与放疗靶区规划，以及治疗后复发与治疗相关改变的鉴别。一体化PET/MRI可在同一检查中同步获取PET分子代谢信息与多参数MRI结构及功能信息，有效辅助上述环节，是脑胶质瘤精准诊疗的重要影像手段。虽然一体化PET/MRI设备在我国逐步普及，但其临床推广仍面临适应证把握、检查流程与参数设置、图像后处理与评价、影像判读一致性及报告规范等挑战。本指南以我国现有一体化PET/MRI设备与显像剂的可及性为前提，以国内外最新循证证据为依据，紧密结合中国临床实践现状，围绕适应证建议、检查与质控流程、图像判读要点及报告规范等关键环节提出推荐意见，旨在为脑胶质瘤诊疗相关影像与临床专业人员提供系统、实用的循证指导。.