TY - JOUR AU - Ceccon, Garry AU - Lohmann, Philipp AU - Stoffels, Gabriele AU - Judov, Natalie AU - Filss, Christian AU - Rapp, Marion AU - Bauer, Elena AU - Hamisch, Christina AU - Ruge, Maximilian I. AU - Kocher, Martin AU - Kuchelmeister, Klaus AU - Sellhaus, Bernd AU - Sabel, Michael AU - Fink, Gereon R. AU - Shah, Nadim J. AU - Langen, Karl-Josef AU - Galldiks, Norbert TI - Dynamic O -(2-$^{18}$ F-fluoroethyl)-L-tyrosine positron emission tomography differentiates brain metastasis recurrence from radiation injury after radiotherapy JO - Neuro-Oncology VL - 19 IS - 2 SN - 1523-5866 CY - Oxford PB - Oxford Univ. Press M1 - FZJ-2017-00120 SP - 281-288 PY - 2017 AB - 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. LB - PUB:(DE-HGF)16 UR - <Go to ISI:>//WOS:000397280500015 C6 - pmid:27471107 DO - DOI:10.1093/neuonc/now149 UR - https://juser.fz-juelich.de/record/825818 ER -