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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

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Value of 18F-FET PET in comparison to stereotactic serial biopsy in the diagnosis of brain lesions

Meeting Abstract

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  • Joacir G. Cordeiro - Department of Stereotactic Neurosurgery, University Clinic of Freiburg, Germany; Department of Neurosurgery, Federal University of Paraná, Brazil
  • C. Rottenburger - Department of Nuclear Medicine, University Clinic of Freiburg, Germany
  • Markus Pinsker - Department of Stereotactic Neurosurgery, University Clinic of Freiburg, Germany
  • Michael Trippel - Department of Stereotactic Neurosurgery, University Clinic of Freiburg, Germany
  • W. Weber - Department of Nuclear Medicine, University Clinic of Freiburg, Germany
  • Guido Nikkhah - Department of Stereotactic Neurosurgery, University Clinic of Freiburg, Germany
  • Thomas Reithmeier - Department of Stereotactic Neurosurgery, University Clinic of Freiburg, Germany

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. DocP1876

doi: 10.3205/10dgnc347, urn:nbn:de:0183-10dgnc3474

Published: September 16, 2010

© 2010 Cordeiro et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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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.