Artikel
Prognostic value of amino-acid PET with FET in 85 patients with newly diagnosed glioma-suspicious intracerebral lesions
Prognostischer Wert des Aminosäure-PET mit FET bei 85 Patienten mit neu diagnostizierten, gliomverdächtigen intrazerebralen Läsionen
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Autoren
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F. Floeth
- Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf
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G. Reifenberger
- Department of Neuropathology, Heinrich-Heine-University, Düsseldorf
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K. J. Langen
- Brain Imaging Center West, Institute of Medicine, Research Center Jülich, Jülich
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D. Pauleit
- Institute of Nuclear Chemistry, Research Center Jülich, Jülich
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H. J. Steiger
- Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf
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M. Sabel
- Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf
| Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
The aim of this prospective study was to determine the prognostic value of metabolic imaging with PET using O-(2-[18F] fluoroethyl)-L-tyrosine (FET) in patients presenting with glioma-suspicious lesions.
Methods
85 consecutive patients with newly diagnosed and untreated glioma suspicious lesions underwent evaluation with contrast-enhanced MRI and FET-PET. In 72 patients, histological diagnosis was obtained by serial biopsy procedures wheareas 13 patients were followed up without histological diagnosis. The initial FET-uptake of each lesion before treatment was correlated to the clinical course and outcome. Clinical follow-up of the patients ranged from 12 months to 7.5 years, with a mean follow-up time of 37 months.
Results
Gliomas were histologically diagnosed in 63 patients. In 9 patients, histology revealed diagnostically unspecific changes including edema, reactive gliosis and microglia activation. All 11 glioblastomas were invariably FET-PET positive, with 10 (91%) patients showing progressive disease and 9 (82%) succumbing to their tumour during follow-up. Among the 22 anaplastic gliomas, 20 were PET positive. Twelve of the patients (60%) showed progressive disease and 10 (50%) died. Two anaplastic gliomas were PET negative and did not progress so far. Twenty-one of the 30 gliomas of WHO grade II were FET positive. Eleven of these patients (52%) showed progressive disease and 5 (24%) died. In contrast, 9 WHO grade II gliomas were FET negative. Among these cases, 8 (89 %) remained stable whereas one patient showed progressive disease. Three of the 9 histologically unspecific lesions were FET positive, all 3 (100%) progressed to glioblastoma. and 2 died (66%). The remaining 6 FET negative and histologically unspecific lesions all remained clinically stable. Two of the 13 lesions without histological diagnosis were FET positive and one progressed to glioblastoma. The other 11 FET-PET negative lesions showed no clinical progression.
Conclusions
Our data indicate that the FET-uptake is a strong prognostic indicator in intracerebral gliomas. More than 95% of the patients with FET-PET negative lesions (27 of 28) demonstrated a benign course without clinical or radiological progression. In contrast, more than 65% of the patients with FET-PET positive lesions (37 of 57) showed progressive disease and 46% of these patients died.
