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The aim of this study was to assess the clinical value of O-(2-¹⁸F-fluoroethyl)-l-tyrosine (¹⁸F-FET) PET in the initial diagnosis of cerebral lesions suggestive of glioma. In a retrospective study, we analyzed the clinical, radiologic, and neuropathologic data of 174 patients (77 women and 97 men; mean age, 45 ± 15 y) who had been referred for neurosurgical assessment of unclear brain lesions and had undergone ¹⁸F-FET PET. Initial histology (n = 168, confirmed after surgery or biopsy) and the clinical course and follow-up MR imaging in 2 patients revealed 66 high-grade gliomas (HGG), 77 low-grade gliomas (LGG), 2 lymphomas, and 25 nonneoplastic lesions (NNL). In a further 4 patients, initial histology was unspecific, but during the course of the disease all patients developed an HGG. The diagnostic value of maximum and mean tumor-to-brain ratios (TBR_max/TBR_mean) of ¹⁸F-FET uptake was …