gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

FET PET in diagnosis of glioma recurrence after multimodal therapy: Is evaluation of uptake kinetics superior to standard ratio methods?

FET PET in der Diagnostik von Gliom-Rezidiven nach multimodaler Therapie: Ist die Analyse der Aufnahme-Kinetik der Standard-Ratio-Methode überlegen?

Meeting Abstract

  • corresponding author J. Mehrkens - Neurochirurgische Universitätsklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • G. Pöpperl - Klinik für Nuklearmedizin, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • J. Herms - Institut für Neuropathologie, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • J.C. Tonn - Neurochirurgische Universitätsklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • K. Tatsch - Klinik für Nuklearmedizin, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • F.W. Kreth - Neurochirurgische Universitätsklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München

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.08.02

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Mehrkens et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Extended analyses of [18F]fluoroethyltyrosine (FET) uptake kinetics were shown to render valuable information in the identification/grading of primary gliomas. The aim of this study was to evaluate, whether dynamic analyses also provide superior results compared to standard tumor/background ratios in predicting tumor grade and/or recurrence in patients with multimodally treated low and high grade gliomas.

Methods: Dynamic FET-PET studies (0-40 min p.i. of 180 MBq FET) were performed in 45 glioma patients (26 WHO II, 7 WHO III, 12 WHO IV) after multimodal therapy with the MRI-based diagnosis (contrast-enhancing lesion) of tumor-recurrence/progression. For the standard method, the tumoral standard uptake value (SUVmax) and the ratio to the background (SUVmax/BG) were derived from a sum image (20 to 40 min p.i.). Dynamic data evaluation consisted of several approaches, including: a) SUV within a 90% isocontour threshold (SUV90) and the respective ratio to the background (SUV90/BG) and b) time to peak analysis. All results were correlated with histopathological findings derived from stereotactic serial biopsies with multimodal (CT, MRI, FET-PET) 3D-trajectory-planning.

Results: The standard method was able to differentiate patients without recurrence (4 patients) from those with recurrent tumors (41 patients). In patients with detected tumor progression/tumor recurrence, the time curves for SUV and SUV/BG ratios between 5 and 40 min p.i. increased slightly and steadily in low grade tumors whereas high grade tumors presented with an early peak arround 10 to 15 min p.i. followed by a decrease thereafter. The calculated sensitivity and specificity for the dynamic analysis was 92%, respectively. The corresponding values for the standard method were sigfnificantly lower (SUVmax/BG: sensitivity and specifity of 62%, respectively).

Conclusions: Analysis of kinetics of FET uptake seems to permit discrimination of tumor-grade in recurrent gliomas after multimodal therapy with high diagnostic accuracy and should thus be considered a valuable complementation to the standard tumor/background ratios.