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000825818 1001_ $$0P:(DE-HGF)0$$aCeccon, Garry$$b0
000825818 245__ $$aDynamic O -(2-$^{18}$ F-fluoroethyl)-L-tyrosine positron emission tomography differentiates brain metastasis recurrence from radiation injury after radiotherapy
000825818 260__ $$aOxford$$bOxford Univ. Press$$c2017
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000825818 520__ $$aBackgroundThe 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.
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000825818 7001_ $$0P:(DE-Juel1)145110$$aLohmann, Philipp$$b1
000825818 7001_ $$0P:(DE-Juel1)131627$$aStoffels, Gabriele$$b2
000825818 7001_ $$0P:(DE-Juel1)143958$$aJudov, Natalie$$b3
000825818 7001_ $$0P:(DE-Juel1)141877$$aFilss, Christian$$b4
000825818 7001_ $$0P:(DE-HGF)0$$aRapp, Marion$$b5
000825818 7001_ $$0P:(DE-HGF)0$$aBauer, Elena$$b6
000825818 7001_ $$0P:(DE-HGF)0$$aHamisch, Christina$$b7
000825818 7001_ $$0P:(DE-HGF)0$$aRuge, Maximilian I.$$b8
000825818 7001_ $$0P:(DE-HGF)0$$aKocher, Martin$$b9
000825818 7001_ $$0P:(DE-HGF)0$$aKuchelmeister, Klaus$$b10
000825818 7001_ $$0P:(DE-HGF)0$$aSellhaus, Bernd$$b11
000825818 7001_ $$0P:(DE-Juel1)165921$$aSabel, Michael$$b12
000825818 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon R.$$b13
000825818 7001_ $$0P:(DE-Juel1)131794$$aShah, Nadim J.$$b14
000825818 7001_ $$0P:(DE-Juel1)131777$$aLangen, Karl-Josef$$b15
000825818 7001_ $$0P:(DE-Juel1)143792$$aGalldiks, Norbert$$b16$$eCorresponding author
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