title: The use of O-(2-18F-fluoroethyl)-L-tyrosine PET in the diagnosis of gliomas located in the brainstem and spinal cord.
abstract: Despite an increasing number of O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) PET studies in supratentorial gliomas, studies regarding the usefulness of 18F-FET PET in brainstem and spinal cord gliomas to date remain scarce.
  
  
  
  Thirty-six 18F-FET PET scans were performed in 29 patients with brainstem (n = 29 scans) or spinal cord glioma (n = 7 scans). In 32 of 36 PET scans, a dynamic acquisition was performed. Fifteen scans in 15 patients were performed to assess newly diagnosed lesions, and 21 scans were obtained during follow-up: for diagnosing tumor progression (n = 15 scans in 14 patients) as well as for treatment monitoring (n = 6 scans in 3 patients). Four patients underwent additional serial scans (range, 1-2), and 3 of these 4 patients were examined for more than one indication. Maximum and mean tumor/brain ratios (TBRmax/mean) of 18F-FET uptake (20-40 min post injection) as well as kinetic 18F-FET uptake parameters were determined. Final diagnoses were confirmed histologically (54%) or by clinical follow-up (46%).
  
  
  
  In all newly diagnosed high-grade (n = 3 patients) and in 5 of 11 patients with low-grade gliomas, 18F-FET uptake was increased (TBRmax ≥2.5 and/or TBRmean ≥1.9). In 2 patients with newly diagnosed gliomas without MR contrast enhancement, 18F-FET PET nevertheless showed increased metabolism. At suspected progression, the combination of TBRs with kinetic 18F-FET parameters correctly identified presence or absence of progressive disease in 9 of 11 patients (82%).
  
  
  
  This preliminary study suggests that 18F-FET PET adds valuable diagnostic information in brainstem and spinal cord glioma, particularly when the diagnostic information derived from MRI is equivocal.
authors.affiliation: Department of Neurology, University of Cologne, Cologne, Germany.|Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Tscherpel
authors.affiliation: Department of Neurology, University of Cologne, Cologne, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Dunkl
authors.affiliation: Department of Neurology, University of Cologne, Cologne, Germany.
authors.forename: Garry
authors.initials: G
authors.lastname: Ceccon
authors.affiliation: Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Stoffels
authors.affiliation: Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.
authors.forename: Natalie
authors.initials: N
authors.lastname: Judov
authors.affiliation: Department of Neurosurgery, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Rapp
authors.affiliation: Department of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Philipp T
authors.initials: PT
authors.lastname: Meyer
authors.affiliation: Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.
authors.forename: Elena Rota
authors.initials: ER
authors.lastname: Kops
authors.affiliation: Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Ermert
authors.affiliation: Department of Neurology, University of Cologne, Cologne, Germany.|Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.
authors.forename: Gereon R
authors.initials: GR
authors.lastname: Fink
authors.affiliation: Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.|Departments of Neurology, University of Aachen, Aachen, Germany.|Section JARA-Brain, Jülich-Aachen Research Alliance (JARA), Jülich, Germany.
authors.forename: Nadim J
authors.initials: NJ
authors.lastname: Shah
authors.affiliation: Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.|Section JARA-Brain, Jülich-Aachen Research Alliance (JARA), Jülich, Germany.|Nuclear Medicine, University of Aachen, Aachen, Germany.
authors.forename: Karl-Josef
authors.initials: KJ
authors.lastname: Langen
authors.affiliation: Department of Neurology, University of Cologne, Cologne, Germany.|Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany.|Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, Cologne, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Galldiks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020295:Brain Stem Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000378:metabolism; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; C545932:(18F)fluoroethyltyrosine; D014443:Tyrosine
keywords: FET; amino acid PET; brainstem glioma; dynamic acquisition; infratentorial