DOI: 10.1007/s00259-018-3992-5Pages: 1626-1635

Use of FET PET in glioblastoma patients undergoing neurooncological treatment including tumour-treating fields: initial experience

1. University Hospital Cologne, Department of Neurology

2. University Hospital Essen, University Duisburg-Essen, Division of Clinical Neuro-Oncology, Department of Neurology

3. Forschungszentrum Juelich, Institute of Neuroscience and Medicine (INM-3,-4)

4. University of Düsseldorf, Department of Neurosurgery

5. University of Essen, Department of Nuclear Medicine

6. University of Essen, Department of Neuropathology

7. University of Aachen, Department of Nuclear Medicine

8. University of Cologne, Center of Integrated Oncology (CIO)

Correspondence to:
Norbert Galldiks
Tel: +49-2461-61-9324
Email: n.galldiks@fz-juelich.de

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Abstract

Purpose

We present our first clinical experience with O-(2-18F-fluoroethyl)-l-tyrosine (FET) PET in patients with high-grade glioma treated with various neurooncological therapies including tumour-treating fields (TTFields) for the differentiation of tumour progression from treatment-related changes.

Methods

We retrospectively assessed 12 patients (mean age 51 ± 12 years, range 33–72 years) with high-grade glioma (11 glioblastomas, 1 gliosarcoma) in whom the treatment regimen included TTFields and who had undergone FET PET scans for differentiation of tumour progression from treatment-related changes. Mean and maximum tumour-to-brain ratios (TBRmean, TBRmax) were calculated. The definitive diagnosis (tumour progression or posttherapeutic changes) was confirmed either by histopathology (4 of 12 patients) or on clinical follow-up.

Results

In all nine patients with confirmed tumour progression, the corresponding FET PET showed increased uptake (TBRmax 3.5 ± 0.6, TBRmean 2.7 ± 0.7). In one of these nine patients, FET PET was consistent with treatment-related changes, whereas standard MRI showed a newly diagnosed contrast-enhancing lesion. In two patients treated solely with TTFields without any other concurrent neurooncological therapy, serial FET PET revealed a decrease in metabolic activity over a follow-up of 6 months or no FET uptake without any signs of tumour progression or residual tumour on conventional MRI.

Conclusion

FET PET may add valuable information in monitoring therapy in individual patients with high-grade glioma undergoing neurooncological treatment including TTFields.

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  • Accepted: Mar 6, 2018
  • Online: Mar 21, 2018

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