Clinical neuroimaging is undergoing a transformation from the purely anatomic techniques of CT and MRI to those that are functional, such as perfusion imaging and BOLD fMRI, as well as to molecular imaging techniques including MRSI and PET. Complementing the already widely available MR-based methods, the advent of PET-CT and the likely emergence of PET-MR suggest a prominent role for PET in functional brain imaging in the near future. The ultimate goal of this work is to combine multimodality and multiparametric imaging to gain the most relevant physiologic information for diagnosis, prognosis, and therapeutic monitoring of patients with CNS-related cancer. An early goal is to define the true extent of tumor infiltration within the brain, that is, that which extends beyond that seen on conventional contrast-enhanced MR images. The rational combination of the parameters discussed here will likely enable that definition in the short term, with the potential to affect positively the way brain tumors are currently treated, and ultimately survival, from this now uniformly devastating disease.

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