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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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FET-PET and MRI imaging for anaplastic glioma (WHO grade III)

Meeting Abstract

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  • Stefanie Huettinger - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Jens Gempt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Patrick Peschke - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Niels Buchmann - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Stefan Foerster - Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Yu-Mi Ryang - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Thomas Pyka - Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Annette Foerschler - Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Claus Zimmer - Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
  • Florian Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocDI.05.09

doi: 10.3205/13dgnc202, urn:nbn:de:0183-13dgnc2026

Published: May 21, 2013

© 2013 Huettinger 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: About 30% of all gliomas are anaplastic gliomas (WHO grade III) and they show a poor prognosis with a mean overall survival of about 2-3years. FET-PET imaging is – in addition to MRI imaging – applied for tumor grading and prognostic stratification. Our objective was to assess the FET-PET tracer uptake in anaplastic gliomas as compared to MRI imaging, histopathology (Ki67) and overall survival.

Method: 40 patients, who underwent glioma resection or biopsy for newly diagnosed or recurrent anaplastic glioma (WHO grade III) and received preoperative MRI and FET-PET imaging were included between 11/2006 and 10/2012. Tumor entity (WHO grade), location, Karnofsky Performance Status Scale, histopathological features (Ki67) as well as overall survival were assessed for evaluation. Tumor volume in FLAIR-weighted MRI images and volume of contrast enhancement in MRI imaging was assessed. In FET-PET imaging, tumor volumes in areas SUV 1,3, SUV 1,6 and SUV 2,0 in contrast to region of interest as well as SUVmax were evaluated and fused to MRI images.

Results: 40 patients (15 female, 25 male) were assessed: 27 astrozytomas, 3 oligodendrogliomas, 10 oligoastrozytomas. The mean tumor volume in MRI imaging was 42,31 cm3 (FLAIR) and 4,01 cm3 (MRI contrast enhancement). The mean tumor volume in FET-PET imaging was 57,58 cm3 for SUV 1,3, 28,01 cm3 for SUV 1,6 and 15,13 cm3 for SUV 2,0. Intersection of tumor volumes in FLAIR images and FET-PET images (0,38 - 0,52) was higher compared to the intersection of MRI contrast enhancement and FET-PET images (0,05 - 0,21). All patients had elevated tracer uptake in FET-PET imaging (SUV > 1,3), median SUVmax was 3,53. The mean Karnofsky Performance Status Scale was 85 %. Median overall survival was 500days after FET-PET imaging. Median Ki67 was 13 %. Preoperative tumor volume in FET-PET and MRI imaging show a correlation to overall survival, but not significantly in this group of patients.

Conclusions: FET-PET imaging may play an important role in the diagnosis of anaplastic glioma. Preoperative tumor volume in FET-PET and MRI imaging show a correlation to overall survival, however it is not significant in this study. All assessed tumors show elevated tracer uptake (SUV > 1,3), tumor volume in FET-PET imaging is higher than in MRI imaging and only shows partial intersection, suggesting that FET-PET imaging may be an important additional tool to detect tumor extent.