The use of dynamic O-(2-18F-fluoroethyl)-L-tyrosine PET in the diagnosis of patients with progressive and recurrent glioma

Norbert Galldiks, Gabriele Stoffels, Christian Filss, Marion Rapp, Tobias Blau, Caroline Tscherpel, Garry Ceccon, Veronika Dunkl, Martin Weinzierl, Michael Stoffel, Michael Sabel, Gereon R. Fink, Nadim J. Shah, Karl Josef Langen

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Background. We evaluated the diagnostic value of static and dynamic O-(2-[18F]fluoroethyl)-l-tyrosine (18F-FET) PET parameters in patients with progressive or recurrent glioma. Methods. We retrospectively analyzed 132 dynamic 18F-FET PET and conventional MRI scans of 124 glioma patients (primary World Health Organization grade II, n = 55; grade III, n = 19; grade IV, n = 50; mean age, 52 ± 14 y). Patients had been referred for PET assessment with clinical signs and/or MRI findings suggestive of tumor progression or recurrence based on Response Assessment in Neuro-Oncology criteria. Maximum and mean tumor/brain ratios of 18F-FET uptake were determined (20-40 min post-injection) as well as tracer uptake kinetics (ie, time to peak and patterns of the time-activity curves). Diagnoses were confirmed histologically (95%) or by clinical follow-up (5%). Diagnostic accuracies of PET and MR parameters for the detection of tumor progression or recurrence were evaluated by receiver operating characteristic analyses/chi-square test. Results. Tumor progression or recurrence could be diagnosed in 121 of 132 cases (92%). MRI and 18F-FET PET findings were concordant in 84% and discordant in 16%. Compared with the diagnostic accuracy of conventional MRI to diagnose tumor progression or recurrence (85%), a higher accuracy (93%) was achieved by 18F-FET PET when a mean tumor/brain ratio ≥2.0 or time to peak <45 min was present (sensitivity, 93%; specificity, 100%; accuracy, 93%; positive predictive value, 100%; P <. 001). Conclusion. Static and dynamic 18F-FET PET parameters differentiate progressive or recurrent glioma from treatment-related nonneoplastic changes with higher accuracy than conventional MRI.

Original languageEnglish
Pages (from-to)1293-1300
Number of pages8
Issue number9
Publication statusPublished - 1 Sep 2015
Externally publishedYes


  • malignant glioma
  • progressive disease
  • tumor recurrence

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