TY  - JOUR
AU  - Maurer, Gabriele D
AU  - Brucker, Daniel P
AU  - Stoffels, Gabriele
AU  - Filipski, Katharina
AU  - Filss, Christian P
AU  - Mottaghy, Felix M.
AU  - Galldiks, Norbert
AU  - Steinbach, Joachim P
AU  - Hattingen, Elke
AU  - Langen, Karl-Josef
TI  - 18 F-FET PET imaging in differentiating glioma progression from treatment-related changes – a single-center experience
JO  - Journal of nuclear medicine
VL  - 61
IS  - 4
SN  - 2159-662X
CY  - New York, NY
PB  - Soc.
M1  - FZJ-2019-04731
SP  - 505-511
PY  - 2020
AB  - In glioma patients, differentiation between tumor progression (TP) and treatment-related changes (TRCs) remains challenging. Difficulties in classifying imaging alterations may result in a delay or an unnecessary discontinuation of treatment. PET using O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET) has been shown to be a useful tool for detecting TP and TRCs. Methods: We retrospectively evaluated 127 consecutive patients with World Health Organization grade II–IV glioma who underwent 18F-FET PET imaging to distinguish between TP and TRCs. 18F-FET PET findings were verified by neuropathology (40 patients) or clinicoradiologic follow-up (87 patients). Maximum tumor-to-brain ratios (TBRmax) of 18F-FET uptake and the slope of the time–activity curves (20–50 min after injection) were determined. The diagnostic accuracy of 18F-FET PET parameters was evaluated by receiver-operating-characteristic analysis and χ2 testing. The prognostic value of 18F-FET PET was estimated using the Kaplan–Meier method. Results: TP was diagnosed in 94 patients (74%) and TRCs in 33 (26%). For differentiating TP from TRCs, receiver-operating-characteristic analysis yielded an optimal 18F-FET TBRmax cutoff of 1.95 (sensitivity, 70%; specificity, 71%; accuracy, 70%; area under the curve, 0.75 ± 0.05). The highest accuracy was achieved by a combination of TBRmax and slope (sensitivity, 86%; specificity, 67%; accuracy, 81%). However, accuracy was poorer when tumors harbored isocitrate dehydrogenase (IDH) mutations (91% in IDH-wild-type tumors, 67% in IDH-mutant tumors, P < 0.001). 18F-FET PET results correlated with overall survival (P < 0.001). Conclusion: In our neurooncology department, the diagnostic performance of 18F-FET PET was convincing but slightly inferior to that of previous reports. 
LB  - PUB:(DE-HGF)16
C6  - pmid:31519802
UR  - <Go to ISI:>//WOS:000530831100030
DO  - DOI:10.2967/jnumed.119.234757
UR  - https://juser.fz-juelich.de/record/865195
ER  -