Artikel
Value of 18F-FET PET in comparison to stereotactic serial biopsy in the diagnosis of brain lesions
Suche in Medline nach
Autoren
Veröffentlicht: | 16. September 2010 |
---|
Gliederung
Text
Objective: The aim of this study was to explore the diagnostic value of positron emission tomography (PET) using the amino acid O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) tracer in patients with newly diagnosed brain lesions in comparison to histological findings obtained from stereotactic serial biopsy.
Methods: Seventeen patients with newly diagnosed brain lesions on MRI underwent 18F-FET PET examination for 18F-FET PET guided stereotactic serial biopsy. The area with highest metabolic activity in PET was chosen as site of biopsy. According to the literature 18F-FET PET uptake ratio >1.6 was considered positive for a neoplasm. High-grade glioma was suspected with 18F-FET PET uptake ratio ≥3.0. The findings obtained from 18F-FET PET were compared to histological examinations and sensitivity as well as positive predictive value of 18F-FET PET was determined.
Results: A mean of 12,2 (SD = ±3,0) brain specimens per patient were obtained by serial stereotactic biopsy. Histological examination revealed high-grade glioma in 11 patients (65%), low-grade glioma in 5 patients (29%) and a non neoplastic lesion in 1 patient (6%). In 15 patients 18F-FET PET uptake ratio was >1.6, presenting a sensitivity of 88% and positive predictive value of 93% for diagnosis of glioma. In 10 patients 18F-FET PET uptake ratio was ≥3, presenting a sensitivity of 73% and positive predictive value of 80% for diagnosis of a malignant glioma. In 13 patients 18F-FET PET uptake ratio was ≥2.5, presenting sensitivity of 91% and positive predictive value of 77% for diagnosis of malignant glioma.
Conclusions: 18F-FET PET is a valuable tool for the diagnostic evaluation of brain lesions and may refine the targeting for serial biopsies. However, despite the high 18F-FET PET-positive predictive value and sensitivity, a histological analysis, is still the “gold standard” for the accurate diagnosis.