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57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Prognostic value of amino-acid PET with FET in 40 patients with newly diagnosed low-grade glioma

Prognostischer Wert des Aminosäure-PET mit FET bei 40 Patienten mit neu diagnostizierten, niedriggradigen Gliomen

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  • corresponding author F. Floeth - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • G. Reifenberger - Neuropathologie, Heinrich-Heine-Universität, Düsseldorf; Brain Imaging Center West
  • K.J. Langen - Institute of Medicine, Research Center Jülich
  • D. Pauleit - Institute of Nuclear Chemistry, Research Center Jülich
  • H.J. Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • M. Sabel - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocFR.08.01

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc050.shtml

Published: May 8, 2006

© 2006 Floeth et al.
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Outline

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Objective: The aim of this prospective study was to determine the prognostic value of metabolic imaging with PET using O-(2-[F18] fluoroethyl)-L-tyrosine (FET) in patients with newly diagnosed diffuse glioma WHO ° II.

Methods: From 2000 to 2004 a group of 40 consecutive patients with newly diagnosed low-grade glioma WHO grade II underwent preoperative evaluation with contrast-enhanced MRI and FET-PET. Histologic diagnosis was obtained by serial biopsy (n=24) or resection (n=16). After operation only MR follow-up was done in 4 monthly intervals, there was no radiation or chemotherapy treatment. The initial FET-uptake of each lesion before treatment was correlated to the clinical course and outcome (mean follow-up 27 months).

Results: Histology revealed a diffuse astrocytoma ° II in 34 cases and a diffuse oligodendroglioma ° II in six cases. (Twenty-six (65%) of the 40 low grade glioma had significant FET-uptake in PET (tumor-brain ratio >1,3). Twelve of these FET positive patients (46 %) showed progressive disease and five (19%) died. In contrast, 14 (35 %) low grade gliomas had no significant FET-uptake (tumor-brain ratio <1,4) and among these FET-negative patients, two (14%) showed progressive disease and one (7%) died. The difference in the progress rates was significant (p<0,02). There was no correlation between rate and time to progression or death and tumor size, contrast enhancement, type of glioma (astrocytoma vs. oligodendroglioma), mass effect of the tumor, initial symptom (seizure vs. focal deficit) and surgical management (biopsy vs. resection).

Conclusions: Our data indicate that the amino-acid uptake in FET-PET is a strong prognostic indicator in low-grade gliomas. Only 15% of the patients with FET-PET negative tumors showed progressive disease. In contrast, 45% of the patients with FET-PET positive tumors had tumor progression and 20% died during a follow-up period of two years.