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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Comparison of contrast clearance analysis (CCA) versus FET/PET-CT in contrast enhancing tumours – preliminary results

Vergleich der CCA Sequenz mit dem FET/PET-CT bei Kontrastmittel-aufnehmenden Hirntumoren – Vorabstudie

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  • presenting/speaker Christopher Wendel - Klinikum Stuttgart, Katharinenhospital, Klinik für Neurochirurgie, Stuttgart, Deutschland
  • Minou Nadji-Ohl - Klinikum Stuttgart, Katharinenhospital, Klinik für Neurochirurgie, Stuttgart, Deutschland
  • Oliver Ganslandt - Klinikum Stuttgart, Katharinenhospital, Klinik für Neurochirurgie, Stuttgart, Deutschland
  • Diana Horvath-Rizea - Klinikum Stuttgart, Katharinenhospital, Neuroradiologische Klinik, Stuttgart, Deutschland
  • Gabriele Pöpperl - Klinikum Stuttgart, Katharinenhospital, Nuklearmedizin, Stuttgart, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV023

doi: 10.3205/19dgnc023, urn:nbn:de:0183-19dgnc0236

Published: May 8, 2019

© 2019 Wendel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Following radio-chemotherapy up to 30% of patients exhibit pseudo-progression in magnet resonance imaging (MRI), a differentiation between vital tumour and necrosis is deemed helpful. Through advanced imaging with O-(2[18-F]-fluoroethyl)-l-tyrosin ((18)F-FET) positron-emission-tomography (PET) a reliable distinction between vital tumor and necrosis is possible, although limited in resolution, availability and radiation is used. In 2015 Zach et al. provided a method making use of MRI contrast dynamic. The CCA (Contrast Clearance Analysis) sequence subtracts the standard T1 postcontrast MRI from a second T1 MRI and generates a color-coded map of the brain. Fast contrast washout is coded blue (tumour), slow contrast uptake red (necrosis).

Our study compares the CCA map to (18)F-FET/PET-CT.

Methods: Contrast MRI (T1) is obtained at 5 min following contrast application; a second T1 MRI is performed after 55-105 min post-contrast injection. Both multiplanar reconstruction sets are loaded in Brainlabs CCA Application. (18)F-FET/PET-CT was performed following standard criteria in our nuclear medicine department. The initial lesion was defined as region of interest (ROI). The metabolic/vascular activity was characterized using CCA and FET/PET-CT imaging.

Results: 12 patients (f:m 3:9) met the inclusion criteria of our retrospective analysis (malignant contrast enhancing brain tumour, unilocular lesion in initial MRI, after treatment according to Stupp protocol and with a FET/PET-CT less than 36 days prior/after CCA). RANO stable disease (SD) was noted in eight, progressive disease (PD) in one, regressive disease (RD) in three patients. In CCA nine showed necrosis, in three tumour was seen. In FET/PET-CT in seven necrosis were noted and in five tumour. 10 patients showed similar results in CCA and subsequent FET/PET-CT.

Conclusion: To our knowledge this is the first study to provide insight in the correlation of CCA and FET/PET-CT, showing corresponding results in 83% of patients. Our initial data suggest that CCA is a beneficial tool in follow up of patients with contrast enhancing brain tumours. Prospective analysis is planned.

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