Artikel
Use of FET PET in glioblastoma patients undergoing neurooncological treatment including tumor-treating fields: Initial experiences
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Veröffentlicht: | 18. Juni 2018 |
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Objective: The aim of this retrospective study was to present our first clinical experiences with O-(2-18F-fluoroethyl)-L-tyrosine (FET) PET in patients with high-grade glioma treated with various neurooncological therapies including tumor-treating fields (TTF) for the differentiation of tumor progression from treatment-related changes.
Methods: We retrospectively assessed twelve patients (mean age 53±11 years; range 39-73 years) with high-grade gliomas (11 glioblastomas, one gliosarcoma) of two university centers in whom the treatment regimen included TTF and who had undergone FET PET scans for the differentiation of tumor progression from treatment-related changes. Mean and maximum tumor-to-brain ratios (TBRmean, TBRmax) were calculated. Definitive diagnosis (tumor progression or posttherapeutic changes) was confirmed either by histopathological results (4 of 12 patients) or clinical follow-up.
Results: In all patients with confirmed tumor progression (n=9), the corresponding FET PET showed increased uptake (TBRmax, 3.5±0.6; TBRmean, 2.7±0.7). In patients treated solely with TTF without any other neurooncological therapy (n=2), serial FET PET revealed a decline of metabolic activity over a follow-up of 6 months or no FET uptake without any signs of tumor progression or residual tumor on conventional MRI. In one patient, FET PET was consistent with treatment-related changes whereas standard MRI showed a newly diagnosed contrast-enhancing lesion.
Conclusion: In single cases, FET PET may add valuable information for monitoring therapy in patients with high-grade gliomas undergoing neurooncological treatment including TTF.