TY  - JOUR
AU  - Lohmann, Philipp
AU  - Piroth, Marc D.
AU  - Sellhaus, Bernd
AU  - Weis, Joachim
AU  - Geisler, Stefanie
AU  - Oros-Peusquens, Ana-Maria
AU  - Mohlberg, Hartmut
AU  - Amunts, Katrin
AU  - Shah, Nadim J.
AU  - Galldiks, Norbert
AU  - Langen, Karl-Josef
TI  - Correlation of Dynamic O-(2-[18F]Fluoroethyl)-L-Tyrosine Positron Emission Tomography, Conventional Magnetic Resonance Imaging, and Whole-Brain Histopathology in a Pretreated Glioblastoma: A Postmortem Study
JO  - World neurosurgery
VL  - 119
SN  - 1878-8750
CY  - Amsterdam
PB  - Elsevier
M1  - FZJ-2018-05373
SP  - e653-e660
PY  - 2018
AB  - ObjectiveAmino acid positron emission tomography (PET) using O-(2-[18F]fluoroethyl)-L-tyrosine (FET) provides important additional information on the extent of viable tumor tissue of glioblastoma compared with magnetic resonance imaging (MRI). Especially after radiochemotherapy, progression of contrast enhancement in MRI is equivocal and may represent either tumor progression or treatment-related changes. Here, the first case comparing postmortem whole-brain histology of a patient with pretreated glioblastoma with dynamic in vivo FET PET and MRI is presented.MethodsA 61-year-old patient with glioblastoma initially underwent partial tumor resection and died 11 weeks after completion of chemoradiation with concurrent temozolomide. Three days before the patient died, a follow-up FET PET and MRI scan indicated tumor progression. Autopsy was performed 48 hours after death. After formalin fixation, a 7-cm bihemispherical segment of the brain containing the entire tumor mass was cut into 3500 consecutive 20μm coronal sections. Representative sections were stained with hematoxylin and eosin stain, cresyl violet, and glial fibrillary acidic protein immunohistochemistry. An experienced neuropathologist identified areas of dense and diffuse neoplastic infiltration, astrogliosis, and necrosis. In vivo FET PET, MRI datasets, and postmortem histology were co-registered and compared by 3 experienced physicians.ResultsIncreased uptake of FET in the area of equivocal contrast enhancement on MRI correlated very well with dense infiltration by vital tumor cells and showed tracer kinetics typical for malignant gliomas. An area of predominantly reactive astrogliosis showed only moderate uptake of FET and tracer kinetics usually observed in benign lesions.ConclusionsThis case report impressively documents the correct imaging of a progressive glioblastoma by FET PET.
LB  - PUB:(DE-HGF)16
C6  - pmid:30077752
UR  - <Go to ISI:>//WOS:000447941300079
DO  - DOI:10.1016/j.wneu.2018.07.232
UR  - https://juser.fz-juelich.de/record/852419
ER  -