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| Home > Publications database > Comparison of 18F-FET and 18F-FDG PET in brain tumors |
| Journal Article | PreJuSER-4846 |
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2009
Elsevier
Amsterdam [u.a.]
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Please use a persistent id in citations: doi:10.1016/j.nucmedbio.2009.05.005
Abstract: The purpose of this study was to compare the diagnostic value of positron emission tomography (PET) using [(18)F]-fluorodeoxyglucose ((18)F-FDG) and O-(2-[(18)F]fluoroethyl)-l-tyrosine ((18)F-FET) in patients with brain lesions suspicious of cerebral gliomas.Fifty-two patients with suspicion of cerebral glioma were included in this study. From 30 to 50 min after injection of 180 MBq (18)F-FET, a first PET scan ((18)F-FET scan) was performed. Thereafter, 240 MBq (18)F-FDG was injected and a second PET scan was acquired from 30 to 60 min after the second injection ((18)F-FET/(18)F-FDG scan). The cerebral accumulation of (18)F-FDG was calculated by decay corrected subtraction of the (18)F-FET scan from the (18)F-FET/(18)F-FDG scan. Tracer uptake was evaluated by visual scoring and by lesion-to-background (L/B) ratios. The imaging results were compared with the histological results and prognosis.Histology revealed 24 low-grade gliomas (LGG) of World Health Organization (WHO) Grade II and 19 high-grade gliomas (HGG) of WHO Grade III or IV, as well as nine others, mainly benign histologies. The gliomas showed increased (18)F-FET uptake (>normal brain) in 86% and increased (18)F-FDG uptake (>white matter) in 35%. (18)F-FET PET provided diagnostically useful delineation of tumor extent while this was impractical with (18)F-FDG due to high tracer uptake in the gray matter. A local maximum in the tumor area for biopsy guidance could be identified with (18)F-FET in 76% and with (18)F-FDG in 28%. The L/B ratios showed significant differences between LGG and HGG for both tracers but considerable overlap so that reliable preoperative grading was not possible. A significant correlation of tracer uptake with overall survival was found with (18)F-FDG only. In some benign lesions like abscesses, increased uptake was observed for both tracers indicating a limited specificity of both techniques.(18)F-FET PET is superior to (18)F-FDG for biopsy guidance and treatment planning of cerebral gliomas. The uptake of (18)F-FDG is associated with prognosis, but the predictive value is limited and a histological evaluation of tumor tissue remains necessary. Therefore, amino acids like (18)F-FET are the preferred PET tracers for the clinical management of cerebral gliomas.
Keyword(s): Adolescent (MeSH) ; Aged (MeSH) ; Brain Neoplasms: pathology (MeSH) ; Brain Neoplasms: radionuclide imaging (MeSH) ; Female (MeSH) ; Fluorodeoxyglucose F18: diagnostic use (MeSH) ; Follow-Up Studies (MeSH) ; Humans (MeSH) ; Male (MeSH) ; Middle Aged (MeSH) ; Positron-Emission Tomography: methods (MeSH) ; Prospective Studies (MeSH) ; Tyrosine: analogs & derivatives (MeSH) ; Tyrosine: diagnostic use (MeSH) ; Young Adult (MeSH) ; O-(2-fluoroethyl)tyrosine ; Tyrosine ; Fluorodeoxyglucose F18 ; J ; Cerebral glioma (auto) ; F-18-FDG (auto) ; Amino acid PET (auto) ; [F-18]fluoroethyl-L-tyrosine (auto)
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