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Serial 18F-FET PET Imaging of Primarily 18F-FET-Negative Glioma- Does It Make Sense?

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Serial 18F-FET PET Imaging of Primarily 18F-FET-Negative Glioma- Does It Make Sense? / Unterrainer, Marcus; Schweisthal, Florian; Suchorska, Bogdana; Wenter, Vera; Schmid-Tannwald, Christine; Fendler, Wolfgang P; Schüller, Ulrich; Bartenstein, Peter; Tonn, Jörg-Christian; Albert, Nathalie L.

in: J NUCL MED, Jahrgang 57, Nr. 8, 08.2016, S. 1177-82.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Unterrainer, M, Schweisthal, F, Suchorska, B, Wenter, V, Schmid-Tannwald, C, Fendler, WP, Schüller, U, Bartenstein, P, Tonn, J-C & Albert, NL 2016, 'Serial 18F-FET PET Imaging of Primarily 18F-FET-Negative Glioma- Does It Make Sense?', J NUCL MED, Jg. 57, Nr. 8, S. 1177-82. https://doi.org/10.2967/jnumed.115.171033

APA

Unterrainer, M., Schweisthal, F., Suchorska, B., Wenter, V., Schmid-Tannwald, C., Fendler, W. P., Schüller, U., Bartenstein, P., Tonn, J-C., & Albert, N. L. (2016). Serial 18F-FET PET Imaging of Primarily 18F-FET-Negative Glioma- Does It Make Sense? J NUCL MED, 57(8), 1177-82. https://doi.org/10.2967/jnumed.115.171033

Vancouver

Unterrainer M, Schweisthal F, Suchorska B, Wenter V, Schmid-Tannwald C, Fendler WP et al. Serial 18F-FET PET Imaging of Primarily 18F-FET-Negative Glioma- Does It Make Sense? J NUCL MED. 2016 Aug;57(8):1177-82. https://doi.org/10.2967/jnumed.115.171033

Bibtex

@article{44cf942dfc1c4fca91d0780906ef2334,
title = "Serial 18F-FET PET Imaging of Primarily 18F-FET-Negative Glioma- Does It Make Sense?",
abstract = "UNLABELLED: PET with O-(2-(18)F-fluoroethyl)-l-tyrosine ((18)F-FET) has gained increasing importance for glioma management. With regard to the occurrence of (18)F-FET-negative glioma, we investigated the value of (18)F-FET PET monitoring of primarily (18)F-FET-negative gliomas concerning the detection of progression and malignant transformation.METHODS: We included 31 patients (26 World Health Organization [WHO] grade II, 5 WHO grade III) with primarily (18)F-FET-negative glioma and available (18)F-FET PET follow-up. (18)F-FET PET analysis comprised maximal tumor-to-background ratio (TBRmax) and dynamic analysis of tumoral (18)F-FET uptake over time (increasing vs. decreasing) including minimal time to peak (TTPmin). PET findings were correlated with MRI and clinical findings of progression as well as histology of recurrent tumors.RESULTS: Twenty-three of 31 patients experienced tumor progression (median progression-free survival, 41.7 mo). Fourteen of 23 patients showed tumoral (18)F-FET uptake concurrent to and 4 of 23 before MRI-derived or clinical signs of tumor progression; 2 of 23 patients presented signs of progression in MRI when no concomitant (18)F-FET PET was available, but subsequent follow-up PET was positive. In 3 of 23 patients, no (18)F-FET uptake was detected at tumor progression. Overall, 20 of 31 primarily (18)F-FET-negative glioma turned (18)F-FET-positive during the follow-up. At first occurrence of tumoral (18)F-FET uptake, TBRmax was significantly higher in patients with malignant transformation (11/20) than in those without malignant progression (3.2 ± 0.9 vs. 1.9 ± 0.5; P = 0.001), resulting in a high detection rate for malignant transformation (for TBRmax > 2.46: sensitivity, 82%; specificity, 89%; negative predictive value, 80%; positive predictive value, 90%; and accuracy, 85%). Although static evaluation was superior to dynamic analysis for the detection of malignant transformation (for TTPmin ≤ 17.5 min: sensitivity, 73%; specificity, 67%; negative predictive value, 67%; positive predictive value, 73%; and accuracy, 70%), short TTPmin was associated with an early malignant transformation in the further disease course. Overall, 18 of 31 patients experienced malignant transformation; of these, 16 of 17 (94%) evaluable patients showed (18)F-FET uptake at the time of malignant transformation.CONCLUSION: (18)F-FET PET monitoring with static and dynamic evaluation is useful even in primarily (18)F-FET-negative glioma, providing a high detection rate of both tumor progression and malignant transformation, partly before further signs of progression in MRI. Hence, (18)F-FET uptake indicating malignant transformation might influence the patient management.",
keywords = "Adult, Aged, Brain Neoplasms, Diagnosis, Differential, False Negative Reactions, Female, Glioma, Humans, Male, Middle Aged, Positron-Emission Tomography, Radiopharmaceuticals, Reproducibility of Results, Sensitivity and Specificity, Subtraction Technique, Tyrosine, Watchful Waiting, Young Adult, Journal Article",
author = "Marcus Unterrainer and Florian Schweisthal and Bogdana Suchorska and Vera Wenter and Christine Schmid-Tannwald and Fendler, {Wolfgang P} and Ulrich Sch{\"u}ller and Peter Bartenstein and J{\"o}rg-Christian Tonn and Albert, {Nathalie L}",
note = "{\textcopyright} 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.",
year = "2016",
month = aug,
doi = "10.2967/jnumed.115.171033",
language = "English",
volume = "57",
pages = "1177--82",
journal = "J NUCL MED",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "8",

}

RIS

TY - JOUR

T1 - Serial 18F-FET PET Imaging of Primarily 18F-FET-Negative Glioma- Does It Make Sense?

AU - Unterrainer, Marcus

AU - Schweisthal, Florian

AU - Suchorska, Bogdana

AU - Wenter, Vera

AU - Schmid-Tannwald, Christine

AU - Fendler, Wolfgang P

AU - Schüller, Ulrich

AU - Bartenstein, Peter

AU - Tonn, Jörg-Christian

AU - Albert, Nathalie L

N1 - © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

PY - 2016/8

Y1 - 2016/8

N2 - UNLABELLED: PET with O-(2-(18)F-fluoroethyl)-l-tyrosine ((18)F-FET) has gained increasing importance for glioma management. With regard to the occurrence of (18)F-FET-negative glioma, we investigated the value of (18)F-FET PET monitoring of primarily (18)F-FET-negative gliomas concerning the detection of progression and malignant transformation.METHODS: We included 31 patients (26 World Health Organization [WHO] grade II, 5 WHO grade III) with primarily (18)F-FET-negative glioma and available (18)F-FET PET follow-up. (18)F-FET PET analysis comprised maximal tumor-to-background ratio (TBRmax) and dynamic analysis of tumoral (18)F-FET uptake over time (increasing vs. decreasing) including minimal time to peak (TTPmin). PET findings were correlated with MRI and clinical findings of progression as well as histology of recurrent tumors.RESULTS: Twenty-three of 31 patients experienced tumor progression (median progression-free survival, 41.7 mo). Fourteen of 23 patients showed tumoral (18)F-FET uptake concurrent to and 4 of 23 before MRI-derived or clinical signs of tumor progression; 2 of 23 patients presented signs of progression in MRI when no concomitant (18)F-FET PET was available, but subsequent follow-up PET was positive. In 3 of 23 patients, no (18)F-FET uptake was detected at tumor progression. Overall, 20 of 31 primarily (18)F-FET-negative glioma turned (18)F-FET-positive during the follow-up. At first occurrence of tumoral (18)F-FET uptake, TBRmax was significantly higher in patients with malignant transformation (11/20) than in those without malignant progression (3.2 ± 0.9 vs. 1.9 ± 0.5; P = 0.001), resulting in a high detection rate for malignant transformation (for TBRmax > 2.46: sensitivity, 82%; specificity, 89%; negative predictive value, 80%; positive predictive value, 90%; and accuracy, 85%). Although static evaluation was superior to dynamic analysis for the detection of malignant transformation (for TTPmin ≤ 17.5 min: sensitivity, 73%; specificity, 67%; negative predictive value, 67%; positive predictive value, 73%; and accuracy, 70%), short TTPmin was associated with an early malignant transformation in the further disease course. Overall, 18 of 31 patients experienced malignant transformation; of these, 16 of 17 (94%) evaluable patients showed (18)F-FET uptake at the time of malignant transformation.CONCLUSION: (18)F-FET PET monitoring with static and dynamic evaluation is useful even in primarily (18)F-FET-negative glioma, providing a high detection rate of both tumor progression and malignant transformation, partly before further signs of progression in MRI. Hence, (18)F-FET uptake indicating malignant transformation might influence the patient management.

AB - UNLABELLED: PET with O-(2-(18)F-fluoroethyl)-l-tyrosine ((18)F-FET) has gained increasing importance for glioma management. With regard to the occurrence of (18)F-FET-negative glioma, we investigated the value of (18)F-FET PET monitoring of primarily (18)F-FET-negative gliomas concerning the detection of progression and malignant transformation.METHODS: We included 31 patients (26 World Health Organization [WHO] grade II, 5 WHO grade III) with primarily (18)F-FET-negative glioma and available (18)F-FET PET follow-up. (18)F-FET PET analysis comprised maximal tumor-to-background ratio (TBRmax) and dynamic analysis of tumoral (18)F-FET uptake over time (increasing vs. decreasing) including minimal time to peak (TTPmin). PET findings were correlated with MRI and clinical findings of progression as well as histology of recurrent tumors.RESULTS: Twenty-three of 31 patients experienced tumor progression (median progression-free survival, 41.7 mo). Fourteen of 23 patients showed tumoral (18)F-FET uptake concurrent to and 4 of 23 before MRI-derived or clinical signs of tumor progression; 2 of 23 patients presented signs of progression in MRI when no concomitant (18)F-FET PET was available, but subsequent follow-up PET was positive. In 3 of 23 patients, no (18)F-FET uptake was detected at tumor progression. Overall, 20 of 31 primarily (18)F-FET-negative glioma turned (18)F-FET-positive during the follow-up. At first occurrence of tumoral (18)F-FET uptake, TBRmax was significantly higher in patients with malignant transformation (11/20) than in those without malignant progression (3.2 ± 0.9 vs. 1.9 ± 0.5; P = 0.001), resulting in a high detection rate for malignant transformation (for TBRmax > 2.46: sensitivity, 82%; specificity, 89%; negative predictive value, 80%; positive predictive value, 90%; and accuracy, 85%). Although static evaluation was superior to dynamic analysis for the detection of malignant transformation (for TTPmin ≤ 17.5 min: sensitivity, 73%; specificity, 67%; negative predictive value, 67%; positive predictive value, 73%; and accuracy, 70%), short TTPmin was associated with an early malignant transformation in the further disease course. Overall, 18 of 31 patients experienced malignant transformation; of these, 16 of 17 (94%) evaluable patients showed (18)F-FET uptake at the time of malignant transformation.CONCLUSION: (18)F-FET PET monitoring with static and dynamic evaluation is useful even in primarily (18)F-FET-negative glioma, providing a high detection rate of both tumor progression and malignant transformation, partly before further signs of progression in MRI. Hence, (18)F-FET uptake indicating malignant transformation might influence the patient management.

KW - Adult

KW - Aged

KW - Brain Neoplasms

KW - Diagnosis, Differential

KW - False Negative Reactions

KW - Female

KW - Glioma

KW - Humans

KW - Male

KW - Middle Aged

KW - Positron-Emission Tomography

KW - Radiopharmaceuticals

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Subtraction Technique

KW - Tyrosine

KW - Watchful Waiting

KW - Young Adult

KW - Journal Article

U2 - 10.2967/jnumed.115.171033

DO - 10.2967/jnumed.115.171033

M3 - SCORING: Journal article

C2 - 27033893

VL - 57

SP - 1177

EP - 1182

JO - J NUCL MED

JF - J NUCL MED

SN - 0161-5505

IS - 8

ER -