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

FET-PET for postoperative control of resection in glioma surgery

Meeting Abstract

  • N. Buchmann - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München
  • J. Gempt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München
  • H. Pape - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München
  • S. Förster - Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar der TU München
  • B. Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München
  • F. Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München

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. DocSA.07.03

DOI: 10.3205/12dgnc343, URN: urn:nbn:de:0183-12dgnc3432

Published: June 4, 2012

© 2012 Buchmann et al.
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Outline

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Objective: Complete removal of tumor mass by surgery is the most important step in glioma therapy. As adjuvant therapies, customized for each patient, like radiation therapy evolve, control of resection and localisation of residual tumor after surgery becomes more important. Current clinical standard for control of resection is MRI with gadolinium contrast. F18-FET is a radiotracer which is easy to produce with a long half-life and thereby applicable for a widespread use also in non-specialized centres. We assessed the value of postoperative FET-PET compared to MRI with regard to sensitivity for detection of residual viable tumor.

Methods: 62 operations for gliomas in 61 patients were performed. Tumor entities comprised all WHO-grades of glioma, that is 2 grade I, 10 grade II, 10 grade III and 39 grade IV tumors. All patients received a postoperative MRI ± Gadolinium and FET-PET within 72 hours after surgery. Detection of residual tumor and volumetry of residual tumor were carried out using a VOI-based standard approach. Results of these evaluations were compared between the two imaging modalities.

Results: Complete resection was confirmed by both imaging modalities in 34 cases, residual tumor was detected consistently in both imaging modalities in 12 cases. In 14 cases PET could detect residual tumor whereas MRI showed none. In 2 cases MRI showed residues which could not be shown in PET. PET-based residual tumor volume was higher than MRI-based with an average volume of 3,0 cm3 vs. 0,8cm3.

Conclusions: Postoperative FET-PET revealed residual tumor with a higher sensitivity than MRI and showed higher tumor volumes. FET-PET seems to be an accurate and highly specific modality for postoperative assessment of residual tumor. It should be used in addition to MRI, but should not be considered as a stand-alone technique in order to replace MRI. Further studies have to be performed to evaluate the clinical benefit and prognostic value of FET-PET control of resection.