Early [18F]FET-PET in Gliomas after Surgical Resection: Comparison with MRI and Histopathology.
BACKGROUND
The precise definition of the post-operative resection status in high-grade gliomas (HGG) is crucial for further management. We aimed to assess the feasibility of assessment of the resection status with early post-operative positron emission tomography (PET) using [18F]O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET).


METHODS
25 patients with the suspicion of primary HGG were enrolled. All patients underwent pre-operative [18F]FET-PET and magnetic resonance imaging (MRI). Intra-operatively, resection status was assessed using 5-aminolevulinic acid (5-ALA). Imaging was repeated within 72 h after neurosurgery. Post-operative [18F]FET-PET was compared with MRI, intra-operative assessment and clinical follow-up.


RESULTS
[18F]FET-PET, MRI and intra-operative assessment consistently revealed complete resection in 12/25 (48%) patients and incomplete resection in 6/25 cases (24%). In 7 patients, PET revealed discordant findings. One patient was re-resected. 3/7 experienced tumor recurrence, 3/7 died shortly after brain surgery.


CONCLUSIONS
Early assessment of the resection status in HGG with [18F]FET-PET seems to be feasible.
Department of Nuclear Medicine, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Germany; Department of Nuclear Medicine, Klinikum Konstanz, Luisenstr. 7a, 78464, Konstanz, Germany.
Benjamin
B
Kläsner
Department of Neurosurgery, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Germany.
Niels
N
Buchmann
Department of Neurosurgery, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Germany.
Jens
J
Gempt
Department of Neurosurgery, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Germany.
Florian
F
Ringel
Department of Nuclear Medicine, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Germany; Department of Nuclear Medicine, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
Constantin
C
Lapa
Department of Nuclear Medicine, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Germany; Department of Nuclear Medicine, Universitätsmedizin Rostock, Gertrudenplatz 1, 18057, Rostock, Germany.
Bernd Joachim
BJ
Krause
D000328:Adult; D000368:Aged; D005260:Female; D005910:Glioma / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*