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@ARTICLE{Unterrainer:825816,
      author       = {Unterrainer, M. and Galldiks, N. and Suchorska, B. and
                      Kowalew, L.-C. and Wenter, V. and Schmid-Tannwald, C. and
                      Niyazi, M. and Bartenstein, P. and Langen, K.-J. and Albert,
                      N. L.},
      title        = {18{F}-{FET} {PET} uptake characteristics in patients with
                      newly diagnosed and untreated brain metastasis},
      journal      = {Journal of nuclear medicine},
      volume       = {58},
      number       = {4},
      issn         = {0161-5505},
      address      = {Reston, Va.},
      publisher    = {SNM84042},
      reportid     = {FZJ-2017-00118},
      pages        = {584-589},
      year         = {2017},
      abstract     = {In patients with brain metastasis, PET using labeled amino
                      acids has gained clinical importance, mainly regarding the
                      differentiation of viable tumor tissue from
                      treatment-related effects. However, there is still limited
                      knowledge concerning the uptake characteristics in patients
                      with newly diagnosed and untreated brain metastases. Hence,
                      we evaluated the uptake characteristics in these patients
                      using dynamic O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET)
                      PET. Methods: Patients with newly diagnosed brain metastases
                      without prior local therapy and 18F-FET PET scanning were
                      retrospectively identified in 2 centers. Static and dynamic
                      PET parameters (maximal/mean tumor-to-brain-ratio
                      [TBRmax/TBRmean], biologic tumor volume [BTV], and
                      time–activity curves with minimal time to peak [TTPmin])
                      were evaluated and correlated with MRI parameters (maximal
                      lesion diameter, volume of contrast enhancement) and
                      originating primary tumor. Results: Forty-five brain
                      metastases in 30 patients were included. Forty of 45
                      metastases $(89\%)$ had a TBRmax ≥ 1.6 and were classified
                      as 18F-FET–positive (median TBRmax, 2.53 [range,
                      1.64–9.47]; TBRmean, 1.86 [range, 1.63–5.48]; and BTV,
                      3.59 mL [range, 0.04–23.98 mL], respectively). In 39 of 45
                      brain metastases eligible for dynamic analysis, a wide range
                      of TTPmin was observed (median, 22.5 min; range, 4.5–47.5
                      min). All 18F-FET–negative metastases had a diameter of
                      ≤ 1.0 cm, whereas metastases with a > 1.0 cm diameter all
                      showed pathologic 18F-FET uptake, which did not correlate
                      with lesion size. The highest variability of uptake
                      intensity was observed within the group of melanoma
                      metastases. Conclusion: Untreated metastases predominantly
                      show increased 18F-FET uptake, and only a third of
                      metastases < 1.0 cm were 18F-FET–negative, most likely
                      because of scanner resolution and partial-volume effects. In
                      metastases > 1.0 cm, 18F-FET uptake intensity was highly
                      variable and independent of tumor size (even
                      intraindividually). 18F-FET PET might provide additional
                      information beyond the tumor extent by reflecting molecular
                      features of a metastasis and might be a useful tool for
                      future clinical applications, for example, response
                      assessment.},
      cin          = {INM-3 / INM-4 / JARA-BRAIN},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406 /
                      $I:(DE-82)080010_20140620$},
      pnm          = {573 - Neuroimaging (POF3-573)},
      pid          = {G:(DE-HGF)POF3-573},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000398249600019},
      pubmed       = {pmid:27754904},
      doi          = {10.2967/jnumed.116.180075},
      url          = {https://juser.fz-juelich.de/record/825816},
}