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| Home > Publications database > Pitfalls in der [18F]-FET-PET-Diagnostik von Hirntumoren |
| Journal Article | FZJ-2017-00035 |
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2015
Thieme
Stuttgart
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Please use a persistent id in citations: doi:10.1055/s-0035-1564177
Abstract: In clinical neuro-oncology structural magnetic resonance imaging (MRI) is currently the investigation of choice for diagnosing brain tumors. In many situations, however, the capacity of MRI identifying non-enhancing tumor or differentiating neoplastic tissue from unspecific treatment-related changes is limited.In the last years positron emission tomography (PET) using radiolabeled amino acids such as O-(2-[18F]-Fluoroethyl)-L-tyrosine (FET) and [11C]-methionine (MET) in combination with MRI has shown a great potential for a more accurate diagnosis of gliomas. The decisive advantage of amino acid PET is a tumor-specific tracer uptake independent from the blood-brain-barrier permeability. In the diagnostics of primary brain tumors the amino acid PET is able to describe the localization, extent and heterogeneity of the metabolic active tumor, which can be used for improved targeting of biopsy as well as planning of resection and radiotherapy by better visualization of tumor margins. Furthermore, following chemo-/radiotherapy amino acid PET can be used for distinguishing tumor recurrence from pseudoprogression and tumor response from pseudoresponse during antiangiogenic treatment.The main advantage of FET compared to MET is the longer half-life of the [18F]-label, which allows a distribution on a wide clinical scale. In addition, FET uptake appears to be more specific for tumor tissue, because there is a higher uptake of MET in inflammatory cells and tissues.Due to the rapidly growing importance and regular use of amino acid PET in many neuro-oncology centers the aim of this review is to highlight the “pitfalls” especially of FET PET diagnostics of brain tumors. The differential diagnosis of newly diagnosed solitary cerebral lesions with or without (circular) contrast enhancement on MRI includes different types of malignant brain tumors, as well as various benign, non-neoplastic lesions such as inflammatory, ischemic, hemorrhagic or traumatic lesions.
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