TY  - JOUR
AU  - Floeth, F.W.
AU  - Sabel, M.
AU  - Ewelt, C.
AU  - Stummer, W.
AU  - Felsberg, J.
AU  - Reifenberger, G.
AU  - Steiger, H.J.
AU  - Stoffels, G.
AU  - Coenen, H.H.
AU  - Langen, K.J.
TI  - Comparison of (18)F-FET PET and 5-ALA fluorescence in cerebral gliomas
JO  - European Journal of Nuclear Medicine and Molecular Imaging
VL  - 38
IS  - 4
SN  - 1619-7070
CY  - Heidelberg [u.a.]
PB  - Springer-Verl.
M1  - PreJuSER-14678
SP  - 731 - 741
PY  - 2011
N1  - The authors wish to thank Suzanne Schaden and Elisabeth Theelen for assistance in the PET studies; Silke Grafmuller, Erika Wabbals and Sascha Rehbein for radiosynthesis of <SUP>18</SUP>F-FET. This work was supported by the Brain Imaging Center West (BICW).
AB  - The aim of the study was to compare presurgical (18)F-fluoroethyl-L: -tyrosine ((18)F-FET) uptake and Gd-diethylenetriaminepentaacetic acid (DTPA) enhancement on MRI (Gd) with intraoperative 5-aminolevulinic acid (5-ALA) fluorescence in cerebral gliomas.(18)F-FET positron emission tomography (PET) was performed in 30 patients with brain lesions suggestive of diffuse WHO grade II or III gliomas on MRI. PET and MRI data were coregistered to guide neuronavigated biopsies before resection. After oral application of 5-ALA, 38 neuronavigated biopsies were taken from predefined tumour areas that were positive or negative for (18)F-FET or Gd and checked for 5-ALA fluorescence. (18)F-FET uptake with a mean tumour to brain ratio ≥1.6 was rated as positive.Of 38 biopsies, 21 corresponded to high-grade glioma tissue (HGG) of WHO grade III (n = 19) or IV (n = 2) and 17 biopsies to low-grade glioma tissue (LGG) of WHO grade II. In biopsies corresponding to HGG, (18)F-FET PET was positive in 86% (18/21), but 5-ALA and Gd in only 57% (12/21). A mismatch between Gd and 5-ALA was observed in 6 of 21 cases of HGG biopsy samples (3 Gd-positive/5-ALA-negative and 3 Gd-negative/5-ALA-positive). In biopsies corresponding to LGG, (18)F-FET was positive in 41% (7/17), while 5-ALA and Gd were negative in all but one instance. All tumour areas with 5-ALA fluorescence were positive on (18)F-FET PET.There are differences between (18)F-FET and 5-ALA uptake in cerebral gliomas owing to a limited sensitivity of 5-ALA to detect tumour tissue especially in LGG. (18)F-FET PET is more sensitive to detect glioma tissue than 5-ALA fluorescence and should be considered as an additional tool in resection planning.
KW  - Adult
KW  - Aged
KW  - Aminolevulinic Acid: metabolism
KW  - Blood-Brain Barrier: metabolism
KW  - Brain Neoplasms: metabolism
KW  - Brain Neoplasms: pathology
KW  - Brain Neoplasms: radionuclide imaging
KW  - Female
KW  - Gadolinium DTPA: diagnostic use
KW  - Glioma: metabolism
KW  - Glioma: pathology
KW  - Glioma: radionuclide imaging
KW  - Humans
KW  - Magnetic Resonance Imaging
KW  - Male
KW  - Middle Aged
KW  - Positron-Emission Tomography
KW  - Spectrometry, Fluorescence
KW  - Tyrosine: analogs & derivatives
KW  - Tyrosine: diagnostic use
KW  - (18F)fluoroethyltyrosine (NLM Chemicals)
KW  - Aminolevulinic Acid (NLM Chemicals)
KW  - Tyrosine (NLM Chemicals)
KW  - Gadolinium DTPA (NLM Chemicals)
KW  - J (WoSType)
LB  - PUB:(DE-HGF)16
C6  - pmid:21153408
UR  - <Go to ISI:>//WOS:000288255500016
DO  - DOI:10.1007/s00259-010-1690-z
UR  - https://juser.fz-juelich.de/record/14678
ER  -