gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Differentiation of tumorous and non-tumorous intracerebral ring-enhancing lesions with positron emission tomography (PET) using the amino acid [18F]-fluoroethyl-l-tyrosine (FET)

Unterscheidung neoplastischer von nicht neoplastischen Läsionen mit Ringenhancement durch ein Aminosäure-PET mit [18F]-fluoroethyl-l-tyrosine (FET)

Meeting Abstract

  • corresponding author F. Floeth - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • K.J. Langen - Brain Imaging Center West, Institute of Medicine, Research Center Jülich
  • D. Pauleit - Institute of Nuclear Chemistry, Research Center Jülich
  • G. Reifenberger - Neuropathologie, Heinrich-Heine-Universität Düsseldorf
  • W. Stummer - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • H.J. Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • M. Sabel - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocFR.08.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2006/06dgnc053.shtml

Veröffentlicht: 8. Mai 2006

© 2006 Floeth et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: The aim of this study was to explore the differential diagnostic value of positron emission tomography (PET) using the amino acid [18F]-fluoroethyl-l-tyrosine (FET) in patients with newly diagnosed solitary intracerebral lesions showing ring-enhancement on contrast-enhanced magnetic resonance imaging (MRI).

Methods: FET-PET analyses were carried out on 15 consecutive patients with intracerebral ring-enhancing lesions. In addition eleven of the patients were studied with 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-PET. In all patients, the main differential diagnosis after MRI was a malignant lesion, in particular glioblastoma multiforme, versus a benign lesion, in particular a brain abscess. Based on FET-PET, a malignant tumor was suspected for lesions showing increased FET-uptake, with a lesion-to-brain ratio ≥1.6 (FET-PET positive). A non-neoplastic lesion was suspected in case of minimal or absent FET-uptake with a lesion-to-brain ratio <1.6 (FET-PET negative). Histologic diagnosis was obtained by serial biopsies in 14 of the 15 patients. One patient refused the biopsy but follow-up indicated an abscess because his lesion regressed under antibiotic therapy.

Results: Histology and clinical follow-up showed high-grade malignant gliomas in 6 patients and non-neoplastic lesions in 9 patients. FET-PET was positive in all 6 glioma patients as well as in 3 out of 9 patients with non-neoplastic lesions, including 2 patients with brain abscesses and 1 patient with a demyelinating lesion. FDG-PET was positive (lesion-to-gray matter ratio ≥0.7) in 4 out of 4 glioma patients and 3 out of 7 patients with non-neoplastic lesions.

Conclusions: Although FET-PET has been shown to be a very valuable method for the diagnostic evaluation of brain tumors, our data indicate a limited specificity of FET-PET, like FDG-PET, for the distinction between neoplastic and non-neoplastic ring-enhancing intracerebral lesions. Thus, histological investigation of biopsy specimens remains mandatory to solve this important differential diagnosis.