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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 11/2004

01.11.2004 | Original Article

Value of O-(2-[18F]fluoroethyl)-l-tyrosine PET for the diagnosis of recurrent glioma

verfasst von: Gabriele Pöpperl, Claudia Götz, Walter Rachinger, Franz-Josef Gildehaus, Jörg-Christian Tonn, Klaus Tatsch

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2004

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Abstract

Purpose

The prognosis of patients with recurrent gliomas depends on reliable and early diagnosis of tumour recurrence after initial therapy. In this context, magnetic resonance imaging (MRI) and computed tomography (CT) often fail to differentiate between radiation- and tumour-induced contrast enhancement. Furthermore, absence of contrast enhancement, or even of 18F-fluorodeoxyglucose uptake in PET, does not exclude recurrence. The aim of this study was to establish the diagnostic value of O-(2-[18F]fluoroethyl)-l-tyrosine (FET) PET in recurrent gliomas.

Methods

Fifty-three patients with glioma (primary grading: 27=WHO grade IV, 16=grade III, 9=grade II, 1=grade I) and clinically suspected recurrence underwent FET PET scans 4–180 months after different treatment modalities. For semiquantitative evaluation, maximal SUV (SUVmax) and mean SUV within 80% and 70% isocontour thresholds (SUV80/SUV70) were evaluated and the respective ratios to the background (BG) were calculated. PET results were correlated with MRI/CT, clinical follow-up or biopsy findings.

Results

All patients presented with FET uptake, of varying intensity, in the area of the primary tumour after initial therapy. In the 42 patients with confirmed recurrence, there was additional distinct focal FET uptake with significantly higher values compared with those in the 11 patients without clinical signs of recurrence and showing only low and homogeneous FET uptake at the margins of the resection cavity. With respect to tumour grading, there was a slight but non-significant increase from WHO II (SUVmax/BG: 2.53±0.28) to WHO III (SUVmax/BG: 2.84±0.49) and WHO IV (SUVmax/BG: 3.55±1.07) recurrence.

Conclusion

FET PET reliably distinguishes between post-therapeutic benign lesions and tumour recurrence after initial treatment of low- and high-grade gliomas.
Literatur
1.
Zurück zum Zitat Goetz C, Riva P, Poepperl G, Gildehaus FJ, Hischa A, Tatsch K, Reulen HJ. Locoregional radioimmunotherapy in selected patients with malignant glioma: experiences, side effects and survival times. J Neurooncol 2003;62:321–8.CrossRefPubMed Goetz C, Riva P, Poepperl G, Gildehaus FJ, Hischa A, Tatsch K, Reulen HJ. Locoregional radioimmunotherapy in selected patients with malignant glioma: experiences, side effects and survival times. J Neurooncol 2003;62:321–8.CrossRefPubMed
2.
Zurück zum Zitat Westphal M, Lamszus K, Hilt D. Intracavitary chemotherapy for glioblastoma: present status and future directions. Acta Neurochir Suppl 2003;88:61–7.PubMed Westphal M, Lamszus K, Hilt D. Intracavitary chemotherapy for glioblastoma: present status and future directions. Acta Neurochir Suppl 2003;88:61–7.PubMed
3.
Zurück zum Zitat Kelly PJ, Daumas-Duport C, Kispert DB, Kall BA, Scheithauer BW, Illig JJ. Imaging-based stereotaxic serial biopsies in untreated intracranial glial neoplasms. J Neurosurg 1987;66:865–74.PubMed Kelly PJ, Daumas-Duport C, Kispert DB, Kall BA, Scheithauer BW, Illig JJ. Imaging-based stereotaxic serial biopsies in untreated intracranial glial neoplasms. J Neurosurg 1987;66:865–74.PubMed
4.
Zurück zum Zitat Nelson SJ. Imaging of brain tumors after therapy. Neuroimaging Clin North Am 1999;9:801–19. Nelson SJ. Imaging of brain tumors after therapy. Neuroimaging Clin North Am 1999;9:801–19.
5.
Zurück zum Zitat Valk PE, Dillon WP. Radiation injury of the brain. Am J Neuroradiol 1991;12:45–62.PubMed Valk PE, Dillon WP. Radiation injury of the brain. Am J Neuroradiol 1991;12:45–62.PubMed
6.
Zurück zum Zitat Earnest FT, Kelly PJ, Scheithauer BW, Kall BA, Cascino TL, Ehman RL, et al. Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy. Radiology 1988;166:823–7.PubMed Earnest FT, Kelly PJ, Scheithauer BW, Kall BA, Cascino TL, Ehman RL, et al. Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy. Radiology 1988;166:823–7.PubMed
7.
Zurück zum Zitat Chamberlain MC, Murovic JA, Levin VA. Absence of contrast enhancement on CT brain scans of patients with supratentorial malignant gliomas. Neurology 1988;38:1371–4.PubMed Chamberlain MC, Murovic JA, Levin VA. Absence of contrast enhancement on CT brain scans of patients with supratentorial malignant gliomas. Neurology 1988;38:1371–4.PubMed
8.
Zurück zum Zitat Di Chiro G. Positron emission tomography using [18F]fluorodeoxyglucose in brain tumors. A powerful diagnostic and prognostic tool. Invest Radiol 1987;22:360–71.PubMed Di Chiro G. Positron emission tomography using [18F]fluorodeoxyglucose in brain tumors. A powerful diagnostic and prognostic tool. Invest Radiol 1987;22:360–71.PubMed
9.
Zurück zum Zitat Patronas NJ, Di Chiro G, Brooks RA, DeLaPaz RL, Kornblith PL, Smith BH, et al. Work in progress: [18F] fluorodeoxyglucose and positron emission tomography in the evaluation of radiation necrosis of the brain. Radiology 1982;144:885–9.PubMed Patronas NJ, Di Chiro G, Brooks RA, DeLaPaz RL, Kornblith PL, Smith BH, et al. Work in progress: [18F] fluorodeoxyglucose and positron emission tomography in the evaluation of radiation necrosis of the brain. Radiology 1982;144:885–9.PubMed
10.
Zurück zum Zitat Di Chiro G, Oldfield E, Wright DC, De Michele D, Katz DA, Patronas NJ, et al. Cerebral necrosis after radiotherapy and/or intraarterial chemotherapy for brain tumors: PET and neuropathologic studies. Am J Roentgenol 1988;150:189–97. Di Chiro G, Oldfield E, Wright DC, De Michele D, Katz DA, Patronas NJ, et al. Cerebral necrosis after radiotherapy and/or intraarterial chemotherapy for brain tumors: PET and neuropathologic studies. Am J Roentgenol 1988;150:189–97.
11.
Zurück zum Zitat Valk PE, Budinger TF, Levin VA, Silver P, Gutin PH, Doyle WK. PET of malignant cerebral tumors after interstitial brachytherapy. Demonstration of metabolic activity and correlation with clinical outcome. J Neurosurg 1988;69:830–8.PubMed Valk PE, Budinger TF, Levin VA, Silver P, Gutin PH, Doyle WK. PET of malignant cerebral tumors after interstitial brachytherapy. Demonstration of metabolic activity and correlation with clinical outcome. J Neurosurg 1988;69:830–8.PubMed
12.
Zurück zum Zitat Ogawa T, Kanno I, Shishido F, Inugami A, Higano S, Fujita H, et al. Clinical value of PET with 18F-fluorodeoxyglucose and l-methyl-11C-methionine for diagnosis of recurrent brain tumor and radiation injury. Acta Radiol 1991;32:197–202.PubMed Ogawa T, Kanno I, Shishido F, Inugami A, Higano S, Fujita H, et al. Clinical value of PET with 18F-fluorodeoxyglucose and l-methyl-11C-methionine for diagnosis of recurrent brain tumor and radiation injury. Acta Radiol 1991;32:197–202.PubMed
13.
Zurück zum Zitat Olivero WC, Dulebohn SC, Lister JR. The use of PET in evaluating patients with primary brain tumours: is it useful? J Neurol Neurosurg Psychiatry 1995;58:250–2.PubMed Olivero WC, Dulebohn SC, Lister JR. The use of PET in evaluating patients with primary brain tumours: is it useful? J Neurol Neurosurg Psychiatry 1995;58:250–2.PubMed
14.
Zurück zum Zitat Ricci PE, Karis JP, Heiserman JE, Fram EK, Bice AN, Drayer BP. Differentiating recurrent tumor from radiation necrosis: time for re-evaluation of positron emission tomography? Am J Neuroradiol 1998;19:407–13.PubMed Ricci PE, Karis JP, Heiserman JE, Fram EK, Bice AN, Drayer BP. Differentiating recurrent tumor from radiation necrosis: time for re-evaluation of positron emission tomography? Am J Neuroradiol 1998;19:407–13.PubMed
15.
Zurück zum Zitat Laverman P, Boerman OC, Corstens FH, Oyen WJ. Fluorinated amino acids for tumour imaging with positron emission tomography. Eur J Nucl Med Mol Imaging 2002;29:681–90.CrossRefPubMed Laverman P, Boerman OC, Corstens FH, Oyen WJ. Fluorinated amino acids for tumour imaging with positron emission tomography. Eur J Nucl Med Mol Imaging 2002;29:681–90.CrossRefPubMed
16.
Zurück zum Zitat Herholz K, Holzer T, Bauer B, Schroder R, Voges J, Ernestus RI, et al. 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 1998;50:1316–22.PubMed Herholz K, Holzer T, Bauer B, Schroder R, Voges J, Ernestus RI, et al. 11C-methionine PET for differential diagnosis of low-grade gliomas. Neurology 1998;50:1316–22.PubMed
17.
Zurück zum Zitat Pruim J, Willemsen AT, Molenaar WM, van Waarde A, Paans AM, Heesters MA, et al. Brain tumors: l-[1-C-11]tyrosine PET for visualization and quantification of protein synthesis rate. Radiology 1995;197:221–6.PubMed Pruim J, Willemsen AT, Molenaar WM, van Waarde A, Paans AM, Heesters MA, et al. Brain tumors: l-[1-C-11]tyrosine PET for visualization and quantification of protein synthesis rate. Radiology 1995;197:221–6.PubMed
18.
Zurück zum Zitat Derlon JM, Bourdet C, Bustany P, Chatel M, Theron J, Darcel F, Syrota A. [11C]l-methionine uptake in gliomas. Neurosurgery 1989;25:720–8.PubMed Derlon JM, Bourdet C, Bustany P, Chatel M, Theron J, Darcel F, Syrota A. [11C]l-methionine uptake in gliomas. Neurosurgery 1989;25:720–8.PubMed
19.
Zurück zum Zitat Mosskin M, Ericson K, Hindmarsh T, von Holst H, Collins VP, Bergstrom M, et al. Positron emission tomography compared with magnetic resonance imaging and computed tomography in supratentorial gliomas using multiple stereotactic biopsies as reference. Acta Radiol 1989;30:225–32.PubMed Mosskin M, Ericson K, Hindmarsh T, von Holst H, Collins VP, Bergstrom M, et al. Positron emission tomography compared with magnetic resonance imaging and computed tomography in supratentorial gliomas using multiple stereotactic biopsies as reference. Acta Radiol 1989;30:225–32.PubMed
20.
Zurück zum Zitat Ogawa T, Shishido F, Kanno I, Inugami A, Fujita H, Murakami M, et al. Cerebral glioma: evaluation with methionine PET. Radiology 1993;186:45–53.PubMed Ogawa T, Shishido F, Kanno I, Inugami A, Fujita H, Murakami M, et al. Cerebral glioma: evaluation with methionine PET. Radiology 1993;186:45–53.PubMed
21.
Zurück zum Zitat Thiel A, Pietrzyk U, Sturm V, Herholz K, Hovels M, Schroder R. Enhanced accuracy in differential diagnosis of radiation necrosis by positron emission tomography–magnetic resonance imaging coregistration: technical case report. Neurosurgery 2000;46:232–4.PubMed Thiel A, Pietrzyk U, Sturm V, Herholz K, Hovels M, Schroder R. Enhanced accuracy in differential diagnosis of radiation necrosis by positron emission tomography–magnetic resonance imaging coregistration: technical case report. Neurosurgery 2000;46:232–4.PubMed
22.
Zurück zum Zitat Tsuyuguchi N, Sunada I, Iwai Y, Yamanaka K, Tanaka K, Takami T, et al. Methionine positron emission tomography of recurrent metastatic brain tumor and radiation necrosis after stereotactic radiosurgery: is a differential diagnosis possible? J Neurosurg 2003;98:1056–64.PubMed Tsuyuguchi N, Sunada I, Iwai Y, Yamanaka K, Tanaka K, Takami T, et al. Methionine positron emission tomography of recurrent metastatic brain tumor and radiation necrosis after stereotactic radiosurgery: is a differential diagnosis possible? J Neurosurg 2003;98:1056–64.PubMed
23.
Zurück zum Zitat Wester HJ, Herz M, Weber W, Heiss P, Senekowitsch-Schmidtke R, Schwaiger M, Stocklin G. Synthesis and radiopharmacology of O-(2-[18F]fluoroethyl)-l-tyrosine for tumor imaging. J Nucl Med 1999;40:205–12.PubMed Wester HJ, Herz M, Weber W, Heiss P, Senekowitsch-Schmidtke R, Schwaiger M, Stocklin G. Synthesis and radiopharmacology of O-(2-[18F]fluoroethyl)-l-tyrosine for tumor imaging. J Nucl Med 1999;40:205–12.PubMed
24.
Zurück zum Zitat Heiss P, Mayer S, Herz M, Wester HJ, Schwaiger M, Senekowitsch-Schmidtke R. Investigation of transport mechanism and uptake kinetics of O-(2-[18F]fluoroethyl)-l-tyrosine in vitro and in vivo. J Nucl Med 1999;40:1367–73.PubMed Heiss P, Mayer S, Herz M, Wester HJ, Schwaiger M, Senekowitsch-Schmidtke R. Investigation of transport mechanism and uptake kinetics of O-(2-[18F]fluoroethyl)-l-tyrosine in vitro and in vivo. J Nucl Med 1999;40:1367–73.PubMed
25.
Zurück zum Zitat Weber WA, Wester HJ, Grosu AL, Herz M, Dzewas B, Feldmann HJ, et al. O-(2-[18F]fluoroethyl)-l-tyrosine and l-[methyl-11C]methionine uptake in brain tumours: initial results of a comparative study. Eur J Nucl Med 2000;27:542–9.CrossRefPubMed Weber WA, Wester HJ, Grosu AL, Herz M, Dzewas B, Feldmann HJ, et al. O-(2-[18F]fluoroethyl)-l-tyrosine and l-[methyl-11C]methionine uptake in brain tumours: initial results of a comparative study. Eur J Nucl Med 2000;27:542–9.CrossRefPubMed
26.
Zurück zum Zitat Miyagawa T, Oku T, Uehara H, Desai R, Beattie B, Tjuvajev J, Blasberg R. “Facilitated” amino acid transport is upregulated in brain tumors. J Cereb Blood Flow Metab 1998;18:500–9.CrossRefPubMed Miyagawa T, Oku T, Uehara H, Desai R, Beattie B, Tjuvajev J, Blasberg R. “Facilitated” amino acid transport is upregulated in brain tumors. J Cereb Blood Flow Metab 1998;18:500–9.CrossRefPubMed
27.
Zurück zum Zitat Pauleit D, Floeth F, Herzog H, Hamacher K, Tellmann L, Muller HW, et al. Whole-body distribution and dosimetry of O-(2-[18F]fluoroethyl)-l-tyrosine. Eur J Nucl Med Mol Imaging 2003;30:519–24.PubMed Pauleit D, Floeth F, Herzog H, Hamacher K, Tellmann L, Muller HW, et al. Whole-body distribution and dosimetry of O-(2-[18F]fluoroethyl)-l-tyrosine. Eur J Nucl Med Mol Imaging 2003;30:519–24.PubMed
28.
Zurück zum Zitat Sato N, Inoue T, Tomiyoshi K, Aoki J, Oriuchi N, Takahashi A, et al. Gliomatosis cerebri evaluated by 18Fα-methyl tyrosine positron-emission tomography. Neuroradiology 2003;45:700–7.CrossRefPubMed Sato N, Inoue T, Tomiyoshi K, Aoki J, Oriuchi N, Takahashi A, et al. Gliomatosis cerebri evaluated by 18Fα-methyl tyrosine positron-emission tomography. Neuroradiology 2003;45:700–7.CrossRefPubMed
29.
Zurück zum Zitat Inoue T, Shibasaki T, Oriuchi N, Aoyagi K, Tomiyoshi K, Amano S, et al. 18F alpha-methyl tyrosine PET studies in patients with brain tumors. J Nucl Med 1999;40:399–405.PubMed Inoue T, Shibasaki T, Oriuchi N, Aoyagi K, Tomiyoshi K, Amano S, et al. 18F alpha-methyl tyrosine PET studies in patients with brain tumors. J Nucl Med 1999;40:399–405.PubMed
30.
Zurück zum Zitat Becherer A, Karanikas G, Szabo M, Zettinig G, Asenbaum S, Marosi C, et al. Brain tumour imaging with PET: a comparison between [18F]fluorodopa and [11C]methionine. Eur J Nucl Med Mol Imaging 2003;30:1561–7.CrossRefPubMed Becherer A, Karanikas G, Szabo M, Zettinig G, Asenbaum S, Marosi C, et al. Brain tumour imaging with PET: a comparison between [18F]fluorodopa and [11C]methionine. Eur J Nucl Med Mol Imaging 2003;30:1561–7.CrossRefPubMed
31.
Zurück zum Zitat Beuthien-Baumann B, Bredow J, Burchert W, Fuchtner F, Bergmann R, Alheit HD, et al. 3-O-methyl-6-[18F]fluoro-l-DOPA and its evaluation in brain tumour imaging. Eur J Nucl Med Mol Imaging 2003;30:1004–8.CrossRefPubMed Beuthien-Baumann B, Bredow J, Burchert W, Fuchtner F, Bergmann R, Alheit HD, et al. 3-O-methyl-6-[18F]fluoro-l-DOPA and its evaluation in brain tumour imaging. Eur J Nucl Med Mol Imaging 2003;30:1004–8.CrossRefPubMed
32.
Zurück zum Zitat Hara T, Kondo T, Kosaka N. Use of 18F-choline and 11C-choline as contrast agents in positron emission tomography imaging-guided stereotactic biopsy sampling of gliomas. J Neurosurg 2003;99:474–9.PubMed Hara T, Kondo T, Kosaka N. Use of 18F-choline and 11C-choline as contrast agents in positron emission tomography imaging-guided stereotactic biopsy sampling of gliomas. J Neurosurg 2003;99:474–9.PubMed
33.
Zurück zum Zitat Uehara H, Miyagawa T, Tjuvajev J, Joshi R, Beattie B, Oku T, et al. Imaging experimental brain tumors with 1-aminocyclopentane carboxylic acid and alpha-aminoisobutyric acid: comparison to fluorodeoxyglucose and diethylenetriaminepentaacetic acid in morphologically defined tumor regions. J Cereb Blood Flow Metab 1997;17:1239–53.PubMed Uehara H, Miyagawa T, Tjuvajev J, Joshi R, Beattie B, Oku T, et al. Imaging experimental brain tumors with 1-aminocyclopentane carboxylic acid and alpha-aminoisobutyric acid: comparison to fluorodeoxyglucose and diethylenetriaminepentaacetic acid in morphologically defined tumor regions. J Cereb Blood Flow Metab 1997;17:1239–53.PubMed
34.
Zurück zum Zitat Wienhard K, Herholz K, Coenen HH, Rudolf J, Kling P, Stocklin G, Heiss WD. Increased amino acid transport into brain tumors measured by PET of l-(2-18F)fluorotyrosine. J Nucl Med 1991;32:1338–46.PubMed Wienhard K, Herholz K, Coenen HH, Rudolf J, Kling P, Stocklin G, Heiss WD. Increased amino acid transport into brain tumors measured by PET of l-(2-18F)fluorotyrosine. J Nucl Med 1991;32:1338–46.PubMed
35.
Zurück zum Zitat Bergstrom M, Ericson K, Hagenfeldt L, Mosskin M, von Holst H, Noren G, et al. PET study of methionine accumulation in glioma and normal brain tissue: competition with branched chain amino acids. J Comput Assist Tomogr 1987;11:208–13.PubMed Bergstrom M, Ericson K, Hagenfeldt L, Mosskin M, von Holst H, Noren G, et al. PET study of methionine accumulation in glioma and normal brain tissue: competition with branched chain amino acids. J Comput Assist Tomogr 1987;11:208–13.PubMed
36.
Zurück zum Zitat Kracht LW, Friese M, Herholz K, Schroeder R, Bauer B, Jacobs A, Heiss WD. Methyl-[11C]-l-methionine uptake as measured by positron emission tomography correlates to microvessel density in patients with glioma. Eur J Nucl Med Mol Imaging 2003;30:868–73.PubMed Kracht LW, Friese M, Herholz K, Schroeder R, Bauer B, Jacobs A, Heiss WD. Methyl-[11C]-l-methionine uptake as measured by positron emission tomography correlates to microvessel density in patients with glioma. Eur J Nucl Med Mol Imaging 2003;30:868–73.PubMed
37.
Zurück zum Zitat Kaim AH, Weber B, Kurrer MO, Westera G, Schweitzer A, Gottschalk J, et al. 18F-FDG and 18F-FET uptake in experimental soft tissue infection. Eur J Nucl Med Mol Imaging 2002;29:648–54.CrossRefPubMed Kaim AH, Weber B, Kurrer MO, Westera G, Schweitzer A, Gottschalk J, et al. 18F-FDG and 18F-FET uptake in experimental soft tissue infection. Eur J Nucl Med Mol Imaging 2002;29:648–54.CrossRefPubMed
Metadaten
Titel
Value of O-(2-[18F]fluoroethyl)-l-tyrosine PET for the diagnosis of recurrent glioma
verfasst von
Gabriele Pöpperl
Claudia Götz
Walter Rachinger
Franz-Josef Gildehaus
Jörg-Christian Tonn
Klaus Tatsch
Publikationsdatum
01.11.2004
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2004
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-004-1590-1

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