title: (18)F-FET-PET guided surgical biopsy and resection in children and adolescence with brain tumors.
abstract: OBJECTIVE
  MRI alone has its limitations for target selection in biopsy or resection in newly diagnosed and pretreated pediatric brain tumor patients. (18)F-FET-PET imaging is considered to identify metabolically active tumor tissue and to differentiate it from therapy-associated changes. We retrospectively analyzed our experience with (18)F-FET-PET in targeted surgical interventions for pediatric brain tumors.
  
  
  METHODS
  In 26 cases with lesions suspicious of a growing brain tumor on MRI, either newly diagnosed or after antitumoral treatment led to (18)F-FET-PET imaging for target selection prior to stereotactic biopsy, navigated open biopsy or navigated microsurgical tumor resection. Indications for (18)F-FET-PET imaging were visualization of metabolic active tumor tissue within diffuse tumors or pretreated lesions as well as depicting their extent.
  
  
  RESULTS
  (18)F-FET-PET integration in surgery was feasible in all patients using stereotaxy or neuronavigation. Sensitivity for tumor detection was 20/24. (18)F-FET-PET was false positive in two pretreated patients.
  
  
  CONCLUSIONS
  (18)F-FET-PET imaging is helpful for target selection and can be integrated in surgical guidance. (18)F-FET-PET image-guided surgical targeting yielded histological diagnosis with decent specificity and high sensitivity in our cohort of pediatric brain tumor patients. Our results warrant further evaluation of (18)F-FET-PET imaging for surgical guidance.
authors.affiliation: Department of Neurosurgery, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Misch
authors.forename: Andreas
authors.initials: A
authors.lastname: Guggemos
authors.forename: Pablo Hernáiz
authors.initials: PH
authors.lastname: Driever
authors.forename: Arend
authors.initials: A
authors.lastname: Koch
authors.forename: Frederik
authors.initials: F
authors.lastname: Grosse
authors.forename: Ingo G
authors.initials: IG
authors.lastname: Steffen
authors.forename: Michail
authors.initials: M
authors.lastname: Plotkin
authors.forename: Ulrich-Wilhelm
authors.initials: UW
authors.lastname: Thomale
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D038361:Neuronavigation / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014443:Tyrosine / Q000031:analogs & derivatives*
chemical_list: C117289:O-(2-fluoroethyl)tyrosine; D019275:Radiopharmaceuticals; D014443:Tyrosine