title: Advances in neuro-oncology imaging.
abstract: Despite the fact that MRI has evolved to become the standard method for diagnosis and monitoring of patients with brain tumours, conventional MRI sequences have two key limitations: the inability to show the full extent of the tumour and the inability to differentiate neoplastic tissue from nonspecific, treatment-related changes after surgery, radiotherapy, chemotherapy or immunotherapy. In the past decade, PET involving the use of radiolabelled amino acids has developed into an important diagnostic tool to overcome some of the shortcomings of conventional MRI. The Response Assessment in Neuro-Oncology working group - an international effort to develop new standardized response criteria for clinical trials in brain tumours - has recommended the additional use of amino acid PET imaging for brain tumour management. Concurrently, a number of advanced MRI techniques such as magnetic resonance spectroscopic imaging and perfusion weighted imaging are under clinical evaluation to target the same diagnostic problems. This Review summarizes the clinical role of amino acid PET in relation to advanced MRI techniques for differential diagnosis of brain tumours; delineation of tumour extent for treatment planning and biopsy guidance; post-treatment differentiation between tumour progression or recurrence versus treatment-related changes; and monitoring response to therapy. An outlook for future developments in PET and MRI techniques is also presented.
authors.affiliation: Institute of Neuroscience and Medicine (INM-3, INM-4) Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, D-52425 Jülich, Germany.|Departments of Nuclear Medicine and Neurology, RWTH Aachen University Clinic, Pauwelsstrasse 30, D-52074 Aachen, Germany.
authors.forename: Karl-Josef
authors.initials: KJ
authors.lastname: Langen
authors.affiliation: Institute of Neuroscience and Medicine (INM-3, INM-4) Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, D-52425 Jülich, Germany.|Department of Neurology, University of Cologne, Kerpener Strasse 62, D-50937 Cologne, Germany.|Center for Integrated Oncology, Josef-Stelzmann-Strasse 9, D-50937 Cologne, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Galldiks
authors.affiliation: Department of Neuroradiology and Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Hattingen
authors.affiliation: Institute of Neuroscience and Medicine (INM-3, INM-4) Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, D-52425 Jülich, Germany.|Departments of Nuclear Medicine and Neurology, RWTH Aachen University Clinic, Pauwelsstrasse 30, D-52074 Aachen, Germany.|Monash Institute of Medical Engineering, Department of Electrical and Computer Systems Engineering, and Monash Biomedical Imaging, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Wellington Road, Melbourne, Victoria 3800, Australia.
authors.forename: Nadim Jon
authors.initials: NJ
authors.lastname: Shah
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000639:trends; D008495:Medical Oncology / Q000639:trends*; D059906:Neuroimaging / Q000639:trends*; D049268:Positron-Emission Tomography / Q000379:methods* / Q000639:trends