Flare Phenomenon in O -(2- 18 F-Fluoroethyl)-l-Tyrosine PET After Resection of Gliomas
PET using -(2- F-fluoroethyl)-l-tyrosine ( F-FET) is useful to detect residual tumor tissue after glioma resection. Recent animal experiments detected reactive changes in F-FET uptake at the rim of the resection cavity within the first 2 wk after resection of gliomas. In the present study, we evalua...
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| Veröffentlicht in: | Journal of Nuclear Medicine 2020-09, Vol.61 (9), p.1294-1299 |
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| creator | Filss, Christian P Schmitz, Ann K Stoffels, Gabriele Stegmayr, Carina Lohmann, Philipp Werner, Jan Michael Sabel, Michael Rapp, Marion Goldbrunner, Roland Neumaier, Bernd Mottaghy, Felix M Shah, N Jon Fink, Gereon R Galldiks, Norbert Langen, Karl-Josef |
| description | PET using
-(2-
F-fluoroethyl)-l-tyrosine (
F-FET) is useful to detect residual tumor tissue after glioma resection. Recent animal experiments detected reactive changes in
F-FET uptake at the rim of the resection cavity within the first 2 wk after resection of gliomas. In the present study, we evaluated pre- and postoperative
F-FET PET scans of glioma patients with particular emphasis on the identification of reactive changes after surgery.
Forty-three patients with cerebral gliomas (9 low-grade, 34 high-grade; 9 primary tumors, 34 recurrent tumors) who had preoperative (time before surgery: median, 23 d; range, 6-44 d) and postoperative
F-FET PET (time after surgery: median, 14 d; range, 5-28 d) were included. PET scans (20-40 min after injection) were evaluated visually for complete or incomplete resection and compared with MRI. Changes in
F-FET uptake were evaluated by tumor-to-brain ratios in residual tumor and by maximum lesion-to-brain ratios near the resection cavity.
Visual analysis of
F-FET PET scans revealed complete resection in 16 of 43 patients and incomplete resection in the remaining patients. PET results were concordant with MRI in 69% of the patients. The maximum lesion-to-brain ratio for
F-FET uptake near the resection cavity was significantly higher than preoperative values (1.59 ± 0.36 vs. 1.14 ± 0.17;
= 43;
< 0.001). In 11 patients (26%), a flare phenomenon was observed, with a considerable increase in
F-FET uptake compared with preoperative values in either the residual tumor (
= 5) or areas remote from the tumor on the preoperative PET scan (
= 6) (2.92 ± 1.24 vs. 1.62 ± 0.75;
< 0.001). Further follow-up in 5 patients showed decreasing
F-FET uptake in the flare areas in 4 patients and progress in 1 patient.
Our study confirmed that
F-FET PET provides valuable information for assessing the success of glioma resection. Postoperative reactive changes at the rim of the resection cavity appear to be mild. However, in 23% of the patients, a postoperative flare phenomenon was observed that warrants further investigation. |
| doi_str_mv | 10.2967/jnumed.119.238568 |
| format | Article |
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-(2-
F-fluoroethyl)-l-tyrosine (
F-FET) is useful to detect residual tumor tissue after glioma resection. Recent animal experiments detected reactive changes in
F-FET uptake at the rim of the resection cavity within the first 2 wk after resection of gliomas. In the present study, we evaluated pre- and postoperative
F-FET PET scans of glioma patients with particular emphasis on the identification of reactive changes after surgery.
Forty-three patients with cerebral gliomas (9 low-grade, 34 high-grade; 9 primary tumors, 34 recurrent tumors) who had preoperative (time before surgery: median, 23 d; range, 6-44 d) and postoperative
F-FET PET (time after surgery: median, 14 d; range, 5-28 d) were included. PET scans (20-40 min after injection) were evaluated visually for complete or incomplete resection and compared with MRI. Changes in
F-FET uptake were evaluated by tumor-to-brain ratios in residual tumor and by maximum lesion-to-brain ratios near the resection cavity.
Visual analysis of
F-FET PET scans revealed complete resection in 16 of 43 patients and incomplete resection in the remaining patients. PET results were concordant with MRI in 69% of the patients. The maximum lesion-to-brain ratio for
F-FET uptake near the resection cavity was significantly higher than preoperative values (1.59 ± 0.36 vs. 1.14 ± 0.17;
= 43;
< 0.001). In 11 patients (26%), a flare phenomenon was observed, with a considerable increase in
F-FET uptake compared with preoperative values in either the residual tumor (
= 5) or areas remote from the tumor on the preoperative PET scan (
= 6) (2.92 ± 1.24 vs. 1.62 ± 0.75;
< 0.001). Further follow-up in 5 patients showed decreasing
F-FET uptake in the flare areas in 4 patients and progress in 1 patient.
Our study confirmed that
F-FET PET provides valuable information for assessing the success of glioma resection. Postoperative reactive changes at the rim of the resection cavity appear to be mild. However, in 23% of the patients, a postoperative flare phenomenon was observed that warrants further investigation.</description><identifier>ISSN: 0161-5505</identifier><identifier>EISSN: 1535-5667</identifier><identifier>EISSN: 2159-662X</identifier><identifier>DOI: 10.2967/jnumed.119.238568</identifier><identifier>PMID: 32005771</identifier><language>eng</language><publisher>United States: Society of Nuclear Medicine</publisher><subject>Adult ; Aged ; Animal research ; Animal tissues ; Brain ; Brain Neoplasms - diagnostic imaging ; Brain Neoplasms - pathology ; Brain Neoplasms - surgery ; Brain tumors ; Evaluation ; Female ; Fluorine isotopes ; Glioma ; Glioma - diagnostic imaging ; Glioma - pathology ; Glioma - surgery ; Humans ; Lesions ; Magnetic resonance imaging ; Male ; Middle Aged ; Neoplasm Grading ; Positron emission ; Positron emission tomography ; Preoperative Period ; Surgery ; Tomography ; Tumors ; Tyrosine ; Tyrosine - analogs & derivatives</subject><ispartof>Journal of Nuclear Medicine, 2020-09, Vol.61 (9), p.1294-1299</ispartof><rights>2020 by the Society of Nuclear Medicine and Molecular Imaging.</rights><rights>Copyright Society of Nuclear Medicine Sep 1, 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-49d28ce0b8776e3ddedefe8cb1277e49d9903bc57c119ee8b90452984bab5cdf3</citedby><cites>FETCH-LOGICAL-c372t-49d28ce0b8776e3ddedefe8cb1277e49d9903bc57c119ee8b90452984bab5cdf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32005771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Filss, Christian P</creatorcontrib><creatorcontrib>Schmitz, Ann K</creatorcontrib><creatorcontrib>Stoffels, Gabriele</creatorcontrib><creatorcontrib>Stegmayr, Carina</creatorcontrib><creatorcontrib>Lohmann, Philipp</creatorcontrib><creatorcontrib>Werner, Jan Michael</creatorcontrib><creatorcontrib>Sabel, Michael</creatorcontrib><creatorcontrib>Rapp, Marion</creatorcontrib><creatorcontrib>Goldbrunner, Roland</creatorcontrib><creatorcontrib>Neumaier, Bernd</creatorcontrib><creatorcontrib>Mottaghy, Felix M</creatorcontrib><creatorcontrib>Shah, N Jon</creatorcontrib><creatorcontrib>Fink, Gereon R</creatorcontrib><creatorcontrib>Galldiks, Norbert</creatorcontrib><creatorcontrib>Langen, Karl-Josef</creatorcontrib><title>Flare Phenomenon in O -(2- 18 F-Fluoroethyl)-l-Tyrosine PET After Resection of Gliomas</title><title>Journal of Nuclear Medicine</title><addtitle>J Nucl Med</addtitle><description>PET using
-(2-
F-fluoroethyl)-l-tyrosine (
F-FET) is useful to detect residual tumor tissue after glioma resection. Recent animal experiments detected reactive changes in
F-FET uptake at the rim of the resection cavity within the first 2 wk after resection of gliomas. In the present study, we evaluated pre- and postoperative
F-FET PET scans of glioma patients with particular emphasis on the identification of reactive changes after surgery.
Forty-three patients with cerebral gliomas (9 low-grade, 34 high-grade; 9 primary tumors, 34 recurrent tumors) who had preoperative (time before surgery: median, 23 d; range, 6-44 d) and postoperative
F-FET PET (time after surgery: median, 14 d; range, 5-28 d) were included. PET scans (20-40 min after injection) were evaluated visually for complete or incomplete resection and compared with MRI. Changes in
F-FET uptake were evaluated by tumor-to-brain ratios in residual tumor and by maximum lesion-to-brain ratios near the resection cavity.
Visual analysis of
F-FET PET scans revealed complete resection in 16 of 43 patients and incomplete resection in the remaining patients. PET results were concordant with MRI in 69% of the patients. The maximum lesion-to-brain ratio for
F-FET uptake near the resection cavity was significantly higher than preoperative values (1.59 ± 0.36 vs. 1.14 ± 0.17;
= 43;
< 0.001). In 11 patients (26%), a flare phenomenon was observed, with a considerable increase in
F-FET uptake compared with preoperative values in either the residual tumor (
= 5) or areas remote from the tumor on the preoperative PET scan (
= 6) (2.92 ± 1.24 vs. 1.62 ± 0.75;
< 0.001). Further follow-up in 5 patients showed decreasing
F-FET uptake in the flare areas in 4 patients and progress in 1 patient.
Our study confirmed that
F-FET PET provides valuable information for assessing the success of glioma resection. Postoperative reactive changes at the rim of the resection cavity appear to be mild. However, in 23% of the patients, a postoperative flare phenomenon was observed that warrants further investigation.</description><subject>Adult</subject><subject>Aged</subject><subject>Animal research</subject><subject>Animal tissues</subject><subject>Brain</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Brain Neoplasms - pathology</subject><subject>Brain Neoplasms - surgery</subject><subject>Brain tumors</subject><subject>Evaluation</subject><subject>Female</subject><subject>Fluorine isotopes</subject><subject>Glioma</subject><subject>Glioma - diagnostic imaging</subject><subject>Glioma - pathology</subject><subject>Glioma - surgery</subject><subject>Humans</subject><subject>Lesions</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Preoperative Period</subject><subject>Surgery</subject><subject>Tomography</subject><subject>Tumors</subject><subject>Tyrosine</subject><subject>Tyrosine - analogs & derivatives</subject><issn>0161-5505</issn><issn>1535-5667</issn><issn>2159-662X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdULtOwzAUtRAIyuMDWJAlljK4-BHH9lhVFJAqFaHCaiXOjUiVxMVOhv49rgoLw9UdzkPnHIRuGZ1xk6vHbT92UM0YMzMutMz1CZowKSSRea5O0YSynBEpqbxAlzFuKaW51vocXQhOqVSKTdDnsi0C4Lcv6H2XrsdNj9eYTDnBTOMlWbajDx6Gr337QFqy2Qcfmz4pnjZ4Xg8Q8DtEcEOTpL7Gz23juyJeo7O6aCPc_P4r9LF82ixeyGr9_LqYr4gTig8kMxXXDmiplcpBVBVUUIN2JeNKQUKNoaJ0UrnUEUCXhmaSG52VRSldVYsrND367oL_HiEOtmuig7YtevBjtFxISg03Sibq_T_q1o-hT-ksz7Kcm4wJnljsyHKpZwxQ211ouiLsLaP2MLo9jm5TIHscPWnufp3H8gD9Kf5WFj8LYHwe</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Filss, Christian P</creator><creator>Schmitz, Ann K</creator><creator>Stoffels, Gabriele</creator><creator>Stegmayr, Carina</creator><creator>Lohmann, Philipp</creator><creator>Werner, Jan Michael</creator><creator>Sabel, Michael</creator><creator>Rapp, Marion</creator><creator>Goldbrunner, Roland</creator><creator>Neumaier, Bernd</creator><creator>Mottaghy, Felix M</creator><creator>Shah, N Jon</creator><creator>Fink, Gereon R</creator><creator>Galldiks, Norbert</creator><creator>Langen, Karl-Josef</creator><general>Society of Nuclear Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>202009</creationdate><title>Flare Phenomenon in O -(2- 18 F-Fluoroethyl)-l-Tyrosine PET After Resection of Gliomas</title><author>Filss, Christian P ; Schmitz, Ann K ; Stoffels, Gabriele ; Stegmayr, Carina ; Lohmann, Philipp ; Werner, Jan Michael ; Sabel, Michael ; Rapp, Marion ; Goldbrunner, Roland ; Neumaier, Bernd ; Mottaghy, Felix M ; Shah, N Jon ; Fink, Gereon R ; Galldiks, Norbert ; Langen, Karl-Josef</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-49d28ce0b8776e3ddedefe8cb1277e49d9903bc57c119ee8b90452984bab5cdf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Animal research</topic><topic>Animal tissues</topic><topic>Brain</topic><topic>Brain Neoplasms - diagnostic imaging</topic><topic>Brain Neoplasms - pathology</topic><topic>Brain Neoplasms - surgery</topic><topic>Brain tumors</topic><topic>Evaluation</topic><topic>Female</topic><topic>Fluorine isotopes</topic><topic>Glioma</topic><topic>Glioma - diagnostic imaging</topic><topic>Glioma - pathology</topic><topic>Glioma - surgery</topic><topic>Humans</topic><topic>Lesions</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Preoperative Period</topic><topic>Surgery</topic><topic>Tomography</topic><topic>Tumors</topic><topic>Tyrosine</topic><topic>Tyrosine - analogs & derivatives</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Filss, Christian P</creatorcontrib><creatorcontrib>Schmitz, Ann K</creatorcontrib><creatorcontrib>Stoffels, Gabriele</creatorcontrib><creatorcontrib>Stegmayr, Carina</creatorcontrib><creatorcontrib>Lohmann, Philipp</creatorcontrib><creatorcontrib>Werner, Jan Michael</creatorcontrib><creatorcontrib>Sabel, Michael</creatorcontrib><creatorcontrib>Rapp, Marion</creatorcontrib><creatorcontrib>Goldbrunner, Roland</creatorcontrib><creatorcontrib>Neumaier, Bernd</creatorcontrib><creatorcontrib>Mottaghy, Felix M</creatorcontrib><creatorcontrib>Shah, N Jon</creatorcontrib><creatorcontrib>Fink, Gereon R</creatorcontrib><creatorcontrib>Galldiks, Norbert</creatorcontrib><creatorcontrib>Langen, Karl-Josef</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of Nuclear Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Filss, Christian P</au><au>Schmitz, Ann K</au><au>Stoffels, Gabriele</au><au>Stegmayr, Carina</au><au>Lohmann, Philipp</au><au>Werner, Jan Michael</au><au>Sabel, Michael</au><au>Rapp, Marion</au><au>Goldbrunner, Roland</au><au>Neumaier, Bernd</au><au>Mottaghy, Felix M</au><au>Shah, N Jon</au><au>Fink, Gereon R</au><au>Galldiks, Norbert</au><au>Langen, Karl-Josef</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Flare Phenomenon in O -(2- 18 F-Fluoroethyl)-l-Tyrosine PET After Resection of Gliomas</atitle><jtitle>Journal of Nuclear Medicine</jtitle><addtitle>J Nucl Med</addtitle><date>2020-09</date><risdate>2020</risdate><volume>61</volume><issue>9</issue><spage>1294</spage><epage>1299</epage><pages>1294-1299</pages><issn>0161-5505</issn><eissn>1535-5667</eissn><eissn>2159-662X</eissn><abstract>PET using
-(2-
F-fluoroethyl)-l-tyrosine (
F-FET) is useful to detect residual tumor tissue after glioma resection. Recent animal experiments detected reactive changes in
F-FET uptake at the rim of the resection cavity within the first 2 wk after resection of gliomas. In the present study, we evaluated pre- and postoperative
F-FET PET scans of glioma patients with particular emphasis on the identification of reactive changes after surgery.
Forty-three patients with cerebral gliomas (9 low-grade, 34 high-grade; 9 primary tumors, 34 recurrent tumors) who had preoperative (time before surgery: median, 23 d; range, 6-44 d) and postoperative
F-FET PET (time after surgery: median, 14 d; range, 5-28 d) were included. PET scans (20-40 min after injection) were evaluated visually for complete or incomplete resection and compared with MRI. Changes in
F-FET uptake were evaluated by tumor-to-brain ratios in residual tumor and by maximum lesion-to-brain ratios near the resection cavity.
Visual analysis of
F-FET PET scans revealed complete resection in 16 of 43 patients and incomplete resection in the remaining patients. PET results were concordant with MRI in 69% of the patients. The maximum lesion-to-brain ratio for
F-FET uptake near the resection cavity was significantly higher than preoperative values (1.59 ± 0.36 vs. 1.14 ± 0.17;
= 43;
< 0.001). In 11 patients (26%), a flare phenomenon was observed, with a considerable increase in
F-FET uptake compared with preoperative values in either the residual tumor (
= 5) or areas remote from the tumor on the preoperative PET scan (
= 6) (2.92 ± 1.24 vs. 1.62 ± 0.75;
< 0.001). Further follow-up in 5 patients showed decreasing
F-FET uptake in the flare areas in 4 patients and progress in 1 patient.
Our study confirmed that
F-FET PET provides valuable information for assessing the success of glioma resection. Postoperative reactive changes at the rim of the resection cavity appear to be mild. However, in 23% of the patients, a postoperative flare phenomenon was observed that warrants further investigation.</abstract><cop>United States</cop><pub>Society of Nuclear Medicine</pub><pmid>32005771</pmid><doi>10.2967/jnumed.119.238568</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Animal research Animal tissues Brain Brain Neoplasms - diagnostic imaging Brain Neoplasms - pathology Brain Neoplasms - surgery Brain tumors Evaluation Female Fluorine isotopes Glioma Glioma - diagnostic imaging Glioma - pathology Glioma - surgery Humans Lesions Magnetic resonance imaging Male Middle Aged Neoplasm Grading Positron emission Positron emission tomography Preoperative Period Surgery Tomography Tumors Tyrosine Tyrosine - analogs & derivatives |
| title | Flare Phenomenon in O -(2- 18 F-Fluoroethyl)-l-Tyrosine PET After Resection of Gliomas |
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