gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

F-18-FET-PET to image brain metastases

Meeting Abstract

  • J. Gempt - Neurochirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • S. Hüttinger - Neurochirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • S. Krieg - Neurochirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • Y.M. Ryang - Neurochirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • E. Shiban - Neurochirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • S. Förster - Nuklearmedizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • A. Förschler - Abteilung für Neuroradiologie, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • B. Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland
  • F. Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.14.04

DOI: 10.3205/12dgnc126, URN: urn:nbn:de:0183-12dgnc1260

Published: June 4, 2012

© 2012 Gempt 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: FET-PET has been proposed to provide diagnostic information on brain metastases. Especially, the differentiation of postoperative or postradiation tissue changes from recurrent tumor during follow-up is of importance and FET-PET might be useful for this purpose. However, standardized uptake values (SUV) for brain metastases are unclear, so far.

Methods: Pts underwent FET-PET and MRI (Flair, T2*, DTI, T1 ± Gd-DTPA) before surgery for brain metastasis. Imaging data were fused (iPlan cranial 3.0). Uptake of FET was quantified by SUV. Imaging contrast was assessed by calculating lesion-to-gray matter ratios. GTV of tumors were assessed by semi-automatic segmentation (iPlan cranial 3.0).

Results: 30 patients were enrolled (origin of neoplasm: 8 breast; 7 NSCLC, 1 SCLC; 6 upper/lower GI, 3 renal, 2 lymphoma, 2 urinary bladder, 1 CUP). 13 pts had received brain radiation prior to surgical resection, 2 pts underwent treatment for recurrent, previously resected and irradiated brain metastases. In 28 pts histopathology revealed vital tumor tissue, in 2 pts necrotic/non vital tissue. All pts with a positive histopathology for vital tumor tissue displayed a SUV in FET-PET above 1.6. Pts with tumor negative histopathology displayed a SUV max below 1.6. Ratio of PET tumor volume (SUV > 1.6) to GTV (MRI + Gd) was 1.43 (SD ± 2.048). FET-PET delineated tumor tissue outside of MRI changes.

Conclusions: In this preliminary study FET-PET provided diagnostic information on newly diagnosed and recurrent (resected and/or previously irradiated) brain metastases. Applying an SUV ratio threshold of 1.6 FET-PET was positive in all pts with positive histopathology for vital tumor tissue and negative in pts harboring no vital tumor tissue. Therefore semiquantitative FET-PET could be helpful for differentiation of tumor progression from treatment associated tissue changes i.e pseudoprogression.