The usefulness of dynamic O-(2-18F-fluoroethyl)-L-tyrosine PET in the clinical evaluation of brain tumors in children and adolescents

TY - JOUR

T1 - The usefulness of dynamic O-(2-18F-fluoroethyl)-L-tyrosine PET in the clinical evaluation of brain tumors in children and adolescents

AU - Dunkl, Veronika

AU - Cleff, Corvin

AU - Stoffels, Gabriele

AU - Judov, Natalie

AU - Sarikaya-Seiwert, Sevgi

AU - Law, Ian

AU - Bøgeskov, Lars

AU - Nysom, Karsten

AU - Andersen, Sofie B

AU - Steiger, Hans-Jakob

AU - Fink, Gereon R

AU - Reifenberger, Guido

AU - Shah, Nadim J

AU - Coenen, Heinz H

AU - Langen, Karl-Josef

AU - Galldiks, Norbert

N1 - © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Experience regarding O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) PET in children and adolescents with brain tumors is limited.Methods: Sixty-nine 18F-FET PET scans of 48 children and adolescents (median age, 13 y; range, 1-18 y) were analyzed retrospectively. Twenty-six scans to assess newly diagnosed cerebral lesions, 24 scans for diagnosing tumor progression or recurrence, 8 scans for monitoring of chemotherapy effects, and 11 scans for the detection of residual tumor after resection were obtained. Maximum and mean tumor-tobrain ratios (TBRs) were determined at 20-40 min after injection, and time-activity curves of 18F-FET uptake were assigned to 3 different patterns: constant increase; peak at greater than 20-40 min after injection, followed by a plateau; and early peak (≤20 min), followed by a constant descent. The diagnostic accuracy of 18F-FET PET was assessed by receiver-operating-characteristic curve analyses using histology or clinical course as a reference.Results: In patients with newly diagnosed cerebral lesions, the highest accuracy (77%) to detect neoplastic tissue (19/26 patients) was obtained when the maximum TBR was 1.7 or greater (area under the curve, 0.80 ± 0.09; sensitivity, 79%; specificity, 71%; positive predictive value, 88%; P 5 0.02). For diagnosing tumor progression or recurrence, the highest accuracy (82%) was obtained when curve patterns 2 or 3 were present (area under the curve, 0.80 ± 0.11; sensitivity, 75%; specificity, 90%; positive predictive value, 90%; P 5 0.02). During chemotherapy, a decrease of TBRswas associatedwith a stable clinical course, and in 2 patients PET detected residual tumor after presumably complete tumor resection.Conclusion: Our findings suggest that 18F-FET PET can add valuable information for clinical decision making in pediatric brain tumor patients.

AB - Experience regarding O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) PET in children and adolescents with brain tumors is limited.Methods: Sixty-nine 18F-FET PET scans of 48 children and adolescents (median age, 13 y; range, 1-18 y) were analyzed retrospectively. Twenty-six scans to assess newly diagnosed cerebral lesions, 24 scans for diagnosing tumor progression or recurrence, 8 scans for monitoring of chemotherapy effects, and 11 scans for the detection of residual tumor after resection were obtained. Maximum and mean tumor-tobrain ratios (TBRs) were determined at 20-40 min after injection, and time-activity curves of 18F-FET uptake were assigned to 3 different patterns: constant increase; peak at greater than 20-40 min after injection, followed by a plateau; and early peak (≤20 min), followed by a constant descent. The diagnostic accuracy of 18F-FET PET was assessed by receiver-operating-characteristic curve analyses using histology or clinical course as a reference.Results: In patients with newly diagnosed cerebral lesions, the highest accuracy (77%) to detect neoplastic tissue (19/26 patients) was obtained when the maximum TBR was 1.7 or greater (area under the curve, 0.80 ± 0.09; sensitivity, 79%; specificity, 71%; positive predictive value, 88%; P 5 0.02). For diagnosing tumor progression or recurrence, the highest accuracy (82%) was obtained when curve patterns 2 or 3 were present (area under the curve, 0.80 ± 0.11; sensitivity, 75%; specificity, 90%; positive predictive value, 90%; P 5 0.02). During chemotherapy, a decrease of TBRswas associatedwith a stable clinical course, and in 2 patients PET detected residual tumor after presumably complete tumor resection.Conclusion: Our findings suggest that 18F-FET PET can add valuable information for clinical decision making in pediatric brain tumor patients.

KW - Adolescent

KW - Brain Neoplasms

KW - Child

KW - Child, Preschool

KW - Disease Progression

KW - Female

KW - Humans

KW - Infant

KW - Male

KW - Neoplasm, Residual

KW - Positron-Emission Tomography

KW - Recurrence

KW - Sensitivity and Specificity

KW - Tyrosine

U2 - 10.2967/jnumed.114.148734

DO - 10.2967/jnumed.114.148734

M3 - Journal article

C2 - 25525183

SN - 0161-5505

VL - 56

SP - 88

EP - 92

JO - The Journal of Nuclear Medicine

JF - The Journal of Nuclear Medicine

IS - 1

ER -