Filss, Christian P., Schmitz, Ann K., Stoffels, Gabriele, Stegmayr, Carina ORCID: 0000-0003-4191-8734, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Werner, Jan Michael, Sabel, Michael, Rapp, Marion, Goldbrunner, Roland, Neumaier, Bernd, Mottaghy, Felix M., Shah, N. Jon ORCID: 0000-0002-8151-6169, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Galldiks, Norbert ORCID: 0000-0002-2485-1796 and Langen, Karl-Josef (2020). Flare Phenomenon in O-(2-F-18-Fluoroethyl)-L-Tyrosine PET After Resection of Gliomas. J. Nucl. Med., 61 (9). S. 1294 - 1300. RESTON: SOC NUCLEAR MEDICINE INC. ISSN 1535-5667

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Abstract

PET using O-(2-F-18-fluoroethyl)-L-tyrosine (F-18-FET) is useful to detect residual tumor tissue after glioma resection. Recent animal experiments detected reactive changes in F-18-FET uptake at the rim of the resection cavity within the first 2 wk after resection of gliomas. In the present study, we evaluated pre- and postoperative F-18-FET PET scans of glioma patients with particular emphasis on the identification of reactive changes after surgery. Methods: Forty-three patients with cerebral gliomas (9 low-grade, 34 high-grade; 9 primary tumors, 34 recurrent tumors) who had preoperative (time before surgery: median, 23 d; range, 6-44 d) and postoperative F-18-FET PET (time after surgery: median, 14 d; range, 5-28 d) were included. PET scans (20-40 min after injection) were evaluated visually for complete or incomplete resection and compared with MRI. Changes in F-18-FET uptake were evaluated by tumor-to-brain ratios in residual tumor and by maximum lesion-to-brain ratios near the resection cavity. Results: Visual analysis of F-18-FET PET scans revealed complete resection in 16 of 43 patients and incomplete resection in the remaining patients. PET results were concordant with MRI in 69% of the patients. The maximum lesion-to-brain ratio for F-18-FET uptake near the resection cavity was significantly higher than preoperative values (1.59 +/- 0.36 vs. 1.14 +/- 0.17; n = 43; P < 0.001). In 11 patients (26%), a flare phenomenon was observed, with a considerable increase in F-18-FET uptake compared with preoperative values in either the residual tumor (n = 5) or areas remote from the tumor on the preoperative PET scan (n = 6) (2.92 +/- 1.24 vs. 1.62 +/- 0.75; P < 0.001). Further follow-up in 5 patients showed decreasing F-18-FET uptake in the flare areas in 4 patients and progress in 1 patient. Conclusion: Our study confirmed that F-18-FET PET provides valuable information for assessing the success of glioma resection. Postoperative reactive changes at the rim of the resection cavity appear to be mild. However, in 23% of the patients, a postoperative flare phenomenon was observed that warrants further investigation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Filss, Christian P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitz, Ann K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stoffels, GabrieleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stegmayr, CarinaUNSPECIFIEDorcid.org/0000-0003-4191-8734UNSPECIFIED
Lohmann, PhilippUNSPECIFIEDorcid.org/0000-0002-5360-046XUNSPECIFIED
Werner, Jan MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabel, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rapp, MarionUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goldbrunner, RolandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neumaier, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mottaghy, Felix M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shah, N. JonUNSPECIFIEDorcid.org/0000-0002-8151-6169UNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Galldiks, NorbertUNSPECIFIEDorcid.org/0000-0002-2485-1796UNSPECIFIED
Langen, Karl-JosefUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-321540
DOI: 10.2967/jnumed.119.238568
Journal or Publication Title: J. Nucl. Med.
Volume: 61
Number: 9
Page Range: S. 1294 - 1300
Date: 2020
Publisher: SOC NUCLEAR MEDICINE INC
Place of Publication: RESTON
ISSN: 1535-5667
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
POSITRON-EMISSION-TOMOGRAPHY; TUMOR; DIAGNOSIS; SURVIVAL; SURGERY; EXTENTMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32154

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