gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

18F-fluorodeoxy-glucose (FDG) and 18F-ethyl-tyrosine (FET) positron emission tomography (PET) for target setting and grading in non contrast enhancing gliomas using neuronavigated biopsies

18F-Fluorodeoxy-Glukose (FDG) und 18F-Ethyl-Tyrosin (FET) Positronen-Emissions-Tomographie (PET) zur Zielpunktbestimmung und zum Gradieren von nicht-kontrastmittelaufnehmenden Gliomen unter Verwendung von neuronavigierten Biospien

Meeting Abstract

  • corresponding author F. Stockhammer - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin
  • U. Thomale - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin
  • M. Plotkin - Klinik für Strahlenheilkunde, Charité - Universitätsmedizin Berlin
  • C. Hartmann - Institut für Neuropathologie, Charité - Universitätsmedizin Berlin
  • C. Woiciechowsky - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 024

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc279.shtml

Published: April 11, 2007

© 2007 Stockhammer et al.
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Outline

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Objective: Even without contrast enhancement gliomas reveal features of anaplasia. As these tumors are heterogeneous, the diagnosis depends on the biopsies origin. High glucose and tyrosine uptake is associated with dismal prognosis in glioma. We investigated the potential of FDG- and FET-PET for grading and target setting for biopsy.

Methods: We included 31 patients with non-contrast enhancing lesion on MRI. FDG-PET was performed in 28 patients 60 min p.i., FET-PET in 13 patients 10 min p.i., consecutively 11 patients had both investigations. neuronavigated biopsy during tumor resection was performed in 27 patients, 4 patients had stereotactic biopsies. Raised FDG uptake within the tumor and the maximum FET uptake, calculating the standard uptake value (SUV), defined the biopsy targets. Specimens were graded using WHO criteria. Cellular density was determined by light microscopy.

Results: 17 of 31 gliomas corresponded to WHO grade II. High FDG-PET uptake was present in 6 anaplastic and 5 low-grade gliomas, and low uptake in 7 and 10 gliomas, respectively. In 13 patients with FET-PET the SUV correlated with cell density, but not tumor grade. In 10 of 11 patients raised FDG uptake matched with maximum FET utilisation.

Conclusions: In our series 45% of non-enhancing lesions were malignant gliomas. FDG-uptake does not correlate with tumor grade, especially due to a low sensitivity of 46%. SUV of FET-PET can be used to define the target for biopsy, by indicating high cellular density. However, histology remains gold standard for tumor grading.