%0 Journal Article
%A Ceccon, Garry
%A Lohmann, Philipp
%A Stoffels, Gabriele
%A Judov, Natalie
%A Filss, Christian
%A Rapp, Marion
%A Bauer, Elena
%A Hamisch, Christina
%A Ruge, Maximilian I.
%A Kocher, Martin
%A Kuchelmeister, Klaus
%A Sellhaus, Bernd
%A Sabel, Michael
%A Fink, Gereon R.
%A Shah, Nadim J.
%A Langen, Karl-Josef
%A Galldiks, Norbert
%T Dynamic O -(2-$^{18}$ F-fluoroethyl)-L-tyrosine positron emission tomography differentiates brain metastasis recurrence from radiation injury after radiotherapy
%J Neuro-Oncology
%V 19
%N 2
%@ 1523-5866
%C Oxford
%I Oxford Univ. Press
%M FZJ-2017-00120
%P 281-288
%D 2017
%X BackgroundThe aim of this study was to investigate the potential of dynamic O-(2-[18F]fluoroethyl)-L-tyrosine (18F-FET) PET for differentiating local recurrent brain metastasis from radiation injury after radiotherapy since contrast-enhanced MRI often remains inconclusive.MethodsSixty-two patients (mean age, 55 ± 11 y) with single or multiple contrast-enhancing brain lesions (n = 76) on MRI after radiotherapy of brain metastases (predominantly stereotactic radiosurgery) were investigated with dynamic 18F-FET PET. Maximum and mean tumor-to-brain ratios (TBRmax, TBRmean) of 18F-FET uptake were determined (20–40 min postinjection) as well as tracer uptake kinetics (ie, time-to-peak and slope of time-activity curves). Diagnoses were confirmed histologically (34%; 26 lesions in 25 patients) or by clinical follow-up (66%; 50 lesions in 37 patients). Diagnostic accuracies of PET parameters for the correct identification of recurrent brain metastasis were evaluated by receiver-operating-characteristic analyses or the chi-square test.ResultsTBRs were significantly higher in recurrent metastases (n = 36) than in radiation injuries (n = 40) (TBRmax 3.3 ± 1.0 vs 2.2 ± 0.4, P < .001; TBRmean 2.2 ± 0.4 vs 1.7 ± 0.3, P < .001). The highest accuracy (88%) for diagnosing local recurrent metastasis could be obtained with TBRs in combination with the slope of time-activity curves (P < .001).ConclusionsThe results of this study confirm previous preliminary observations that the combined evaluation of the TBRs of 18F-FET uptake and the slope of time-activity curves can differentiate local brain metastasis recurrence from radiation-induced changes with high accuracy. 18F-FET PET may thus contribute significantly to the management of patients with brain metastases.
%F PUB:(DE-HGF)16
%9 Journal Article
%U <Go to ISI:>//WOS:000397280500015
%$ pmid:27471107
%R 10.1093/neuonc/now149
%U https://juser.fz-juelich.de/record/825818