Document Detail

[18F]-fluoro-ethyl-L-tyrosine PET: a valuable diagnostic tool in neuro-oncology, but not all that glitters is glioma.
MedLine Citation:
PMID:  23335162     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To assess the sensitivity and specificity of [(18)F]-fluoro-ethyl-l-tyrosine ((18)F-FET) PET in brain tumors and various non-neoplastic neurologic diseases.
METHODS: We retrospectively evaluated (18)F-FET PET scans from 393 patients grouped into 6 disease categories according to histology (n = 299) or distinct MRI findings (n = 94) (low-grade/high-grade glial/nonglial brain tumors, inflammatory lesions, and other lesions). (18)F-FET PET was visually assessed as positive or negative. Maximum lesion-to-brain ratios (LBRs) were calculated and compared with MRI contrast enhancement (CE), which was graded visually on a 3-point scale (no/moderate/intense).
RESULTS: Sensitivity and specificity for the detection of brain tumor were 87% and 68%, respectively. Significant differences in LBRs were detected between high-grade brain tumors (LBR, 2.04 ± 0.72) and low-grade brain tumors (LBR, 1.52 ± 0.70; P < .001), as well as among inflammatory (LBR, 1.66 ± 0.33; P = .056) and other brain lesions (LBR, 1.10 ± 0.37; P < .001). Gliomas (n = 236) showed (18)F-FET uptake in 80% of World Health Organization (WHO) grade I, 79% of grade II, 92% of grade III, and 100% of grade IV tumors. Low-grade oligodendrogliomas, WHO grade II, had significantly higher (18)F-FET uptakes than astrocytomas grades II and III (P = .018 and P = .015, respectively). (18)F-FET uptake showed a strong association with CE on MRI (P < .001) and was also positive in 52% of 157 nonglial brain tumors and nonneoplastic brain lesions.
CONCLUSIONS: (18)F-FET PET has a high sensitivity for the detection of high-grade brain tumors. Its specificity, however, is limited by passive tracer influx through a disrupted blood-brain barrier and (18)F-FET uptake in nonneoplastic brain lesions. Gliomas show specific tracer uptake in the absence of CE on MRI, which most likely reflects biologically active tumor.
Markus Hutterer; Martha Nowosielski; Daniel Putzer; Nathalie L Jansen; Marcel Seiz; Michael Schocke; Mark McCoy; Georg Göbel; Christian la Fougère; Irene J Virgolini; Eugen Trinka; Andreas H Jacobs; Günther Stockhammer
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-17
Journal Detail:
Title:  Neuro-oncology     Volume:  15     ISSN:  1523-5866     ISO Abbreviation:  Neuro-oncology     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-22     Completed Date:  2013-08-06     Revised Date:  2014-03-06    
Medline Journal Info:
Nlm Unique ID:  100887420     Medline TA:  Neuro Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  341-51     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Blood-Brain Barrier / pathology,  radionuclide imaging
Brain Neoplasms / pathology,  radionuclide imaging*
Fluorodeoxyglucose F18 / diagnostic use*
Follow-Up Studies
Glioma / pathology,  radionuclide imaging*
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Middle Aged
Neoplasm Grading
Positron-Emission Tomography*
Radiopharmaceuticals / diagnostic use*
Retrospective Studies
Sensitivity and Specificity
Tyrosine / analogs & derivatives*,  diagnostic use
Young Adult
Reg. No./Substance:
0/O-(2-fluoroethyl)tyrosine; 0/Radiopharmaceuticals; 0Z5B2CJX4D/Fluorodeoxyglucose F18; 42HK56048U/Tyrosine
Comment In:
Neuro Oncol. 2013 Jul;15(7):816-7   [PMID:  23749786 ]
Neuro Oncol. 2013 Jul;15(7):814-5   [PMID:  23788269 ]

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