Ceccon, Garry, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Stoffels, Gabriele ORCID: 0000-0001-7114-1941, Judov, Natalie ORCID: 0000-0002-3909-9306, Filss, Christian P., Rapp, Marion, Bauer, Elena, Hamisch, Christina, Ruge, Maximilian I., Kocher, Martin, Kuchelmeister, Klaus, Sellhaus, Bernd, Sabel, Michael, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Shah, Nadim J., Langen, Karl-Josef ORCID: 0000-0003-1101-5075 and Galldiks, Norbert ORCID: 0000-0002-2485-1796 (2017). Dynamic O-(2-18F-fluoroethyl)-L-tyrosine positron emission tomography differentiates brain metastasis recurrence from radiation injury after radiotherapy. Neuro-Oncology, 19 (2). S. 281 - 289. CARY: OXFORD UNIV PRESS INC. ISSN 1523-5866

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Abstract

Background. The aim of this study was to investigate the potential of dynamic O-(2-[F-18] fluoroethyl)-L-tyrosine (18FFET) PET for differentiating local recurrent brain metastasis from radiation injury after radiotherapy since contrastenhanced MRI often remains inconclusive. Methods. Sixty-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 (TBR max, TBR mean) 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. Results. TBRs were significantly higher in recurrent metastases (n = 36) than in radiation injuries (n = 40) (TBR max 3.3 +/- 1.0 vs 2.2 +/- 0.4, P <.001; TBR mean 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). Conclusions. The 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Ceccon, GarryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lohmann, PhilippUNSPECIFIEDorcid.org/0000-0002-5360-046XUNSPECIFIED
Stoffels, GabrieleUNSPECIFIEDorcid.org/0000-0001-7114-1941UNSPECIFIED
Judov, NatalieUNSPECIFIEDorcid.org/0000-0002-3909-9306UNSPECIFIED
Filss, Christian P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rapp, MarionUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauer, ElenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamisch, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruge, Maximilian I.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kocher, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuchelmeister, KlausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sellhaus, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabel, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Shah, Nadim J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langen, Karl-JosefUNSPECIFIEDorcid.org/0000-0003-1101-5075UNSPECIFIED
Galldiks, NorbertUNSPECIFIEDorcid.org/0000-0002-2485-1796UNSPECIFIED
URN: urn:nbn:de:hbz:38-241884
DOI: 10.1093/neuonc/now149
Journal or Publication Title: Neuro-Oncology
Volume: 19
Number: 2
Page Range: S. 281 - 289
Date: 2017
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1523-5866
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LOW-GRADE GLIOMA; STEREOTACTIC RADIOSURGERY; F-18-FET PET; O-(2-F-18-FLUOROETHYL)-L-TYROSINE PET; FET PET; TUMOR RECURRENCE; IMAGING CHANGES; UPTAKE KINETICS; NECROSIS; DIAGNOSISMultiple languages
Oncology; Clinical NeurologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/24188

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