• World Neurosurg · May 2018

    Comparative Study

    Comparison of O-(2-18F-Fluoroethyl)-L-Tyrosine Positron Emission Tomography and Perfusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Patients with Progressive and Recurrent Glioma: A Hybrid Positron Emission Tomography/Magnetic Resonance Study.

    • Antoine Verger, Christian P Filss, Philipp Lohmann, Gabriele Stoffels, Michael Sabel, Hans-J Wittsack, Elena Rota Kops, Norbert Galldiks, Gereon R Fink, Nadim J Shah, and Karl-Josef Langen.
    • Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Jülich, Jülich, Germany; Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy, Lorraine University, Nancy, France; IADI, INSERM, UMR 947, Lorraine University, Nancy, France. Electronic address: a.verger@chru-nancy.fr.
    • World Neurosurg. 2018 May 1; 113: e727-e737.

    ObjectiveTo compare the diagnostic performance of O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) positron emission tomography (PET) and perfusion-weighted magnetic resonance imaging (PWI) for the diagnosis of progressive or recurrent glioma.MethodsThirty-two pretreated gliomas (25 progressive or recurrent tumors, 7 treatment-related changes) were investigated with 18F-FET PET and PWI via a hybrid PET/magnetic resonance scanner. Volumes of interest with a diameter of 16 mm were centered on the maximum of abnormality in the tumor area in PET and PWI maps (relative cerebral blood volume, relative cerebral blood flow, mean transit time) and the contralateral unaffected hemisphere. Mean and maximum tumor-to-brain ratios as well as dynamic data for 18F-FET uptake were calculated. Diagnostic accuracies were evaluated by receiver operating characteristic analyses, calculating the area under the curve.Results18F-FET PET showed a significant greater sensitivity to detect abnormalities in pretreated gliomas than PWI (76% vs. 52%, P = 0.03). The maximum tumor-to-brain ratio of 18F-FET PET was the only parameter that discriminated treatment-related changes from progressive or recurrent gliomas (area under the curve, 0.78; P = 0.03, best cut-off 2.61; sensitivity 80%, specificity 86%, accuracy 81%). Among patients with signal abnormality in both modalities, 75% revealed spatially incongruent local hot spots.ConclusionsThis pilot study suggests that 18F-FET PET is superior to PWI to diagnose progressive or recurrent glioma.Copyright © 2018 Elsevier Inc. All rights reserved.

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