gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

FET-PET for postoperative control of resection of malignant gliomas

Meeting Abstract

  • Niels Buchmann - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
  • Jens Gempt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
  • Benjamin Kläsner - Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
  • Haiko Pape - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
  • Annette Förschler - Abteilung für Neuroradiologie, Institut für Röntgendiagnostik, Klinikum rechts der Isar der TU München, Deutschland
  • Friederike Schmidt - Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland
  • Florian Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1572

DOI: 10.3205/10dgnc047, URN: urn:nbn:de:0183-10dgnc0479

Published: September 16, 2010

© 2010 Buchmann et al.
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Outline

Text

Objective: Complete resection is an important prognostic factor in the therapy of gliomas. Hence the postoperative control of the extent of resection is important for the estimation of a patient's prognosis and for the planning of further adjuvant therapies. Postoperative control of resection is carried out by MRI, currently. However, there can be a discrepancy between MRI and the biological imaging by FET-PET concerning exact localization and extent of the tumor. The aim of the present study was the evaluation of the role of FET-PET in the postoperative resection control in comparison to MRI.

Methods: A series of 31 patients harboring FET-positive (prior to surgery) gliomas (21 glioblastomas, 4 anaplastic astrocytomas, 5 diffuse astrocytomas, 1 pilocytic astrocytoma) were examined after surgical resection by MRI ± contrast agent and FET-PET. Imaging data were analyzed for presence and extent and localization of residual tumor tissue. MRI and PET results were compared.

Results: Concordant results were found for 21 patients in both imaging modalities concerning presence, extent and localisation of residual tumor. In 5 cases (16%) PET revealed residual tumor despite a tumor free MRI, in 1 case (3%) the suspicion of residual tumor in MRI could be excluded by PET. In 2 cases (6%) both imaging modalities showed residual tumor in contrary to the intraoperative estimation of a complete resection. In 2 cases, FET-PET was done in an interval of several days after surgery, therefore a reliable differentiation of residual tumor from unspecific changes was not possible.

Conclusions: We found a very good correlation of postoperative FET-PET and MRI in 81% of the evaluated cases. However, in 19% MRI and FET-PET showed discordant results. Due to the biological mechanism underlying FET-PET we suspect a higher sensitivity for detection of residual tumor than for MRI. However, to verify this hypothesis a higher number of patients has to be examined.

It is conceivable, that FET-PET might help predicting localization of recurring tumor already in the postoperative control and so might help in planning a customized therapy for each patient.