Abstracts der 52. DGN-Jahrestagung 2014
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Neuroonkologie 10:30 - 11:30 Niedersachsenhalle B |
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V193 The use of dynamic O-(2-18F-fluoroethyl)-L-tyrosine PET in the diagnosis of patients with progressive and recurrent glioma N. Galldiks1, G. Stoffels2, C. Filss2, V. Dunkl2, M. Rapp3, M. Sabel3, M. I. Ruge4, R. Goldbrunner5, N. J. Shah2, G. R. Fink1, H. H. Coenen2, K. J. Langen2 1Uniklinik Köln, Klinik und Poliklinik für Neurologie, Köln; 2Forschungszentrum Jülich, Institut für Neurowissenschaften und Medizin, Jülich; 3Uniklinik Düsseldorf, Klinik und Poliklinik für Neurochirurgie, Düsseldorf; 4Uniklinik Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln; 5Uniklinik Köln, Klinik und Poliklinik für allgemeine Neurochirurgie, Köln | |
Ziel/Aim: A number of studies suggest that dynamic O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET is helpful for differentiating between high- and low-grade glioma. We here evaluated the diagnostic value of dynamic FET PET in patients with progressive/recurrent glioma.Methodik/Methods: 106 dynamic FET PET and conventional MRI scans of 100 glioma patients (primary WHO grading: grade II, n=55; grade III, n=19; grade IV, n=26) (mean age, 50±14 y) were analyzed retrospectively. Patients were consecutively referred for PET-assessment with MRI findings i) suggestive of tumor progression/recurrence (i.e., based on RANO criteria) (91%), or ii) inconclusive to rule out tumor progression/recurrence (9%).Maximum and mean tumor/brain ratios (TBRmax, TBRmean) of FET uptake were determined (20-40 min post injection). Time-activity curves (TAC) of FET uptake in the tumors were generated and time-to-peak (TTP) was calculated. Furthermore, TACs of each lesion were assigned to one of the following curve patterns: (I) constantly increasing FET uptake without identifiable peak uptake; (II) FET uptake peaking at a midway point (>20-40 min) followed by a plateau; and (III) FET uptake peaking early (≤20 min) followed by a constant descent.Diagnoses were confirmed histologically (93%) or by clinical follow-up (7%). Diagnostic accuracy of PET and MR parameters was evaluated by ROC analyses.Ergebnisse/Results: Tumor progression/recurrence could be diagnosed in 95 of 106 cases (90%). MRI and FET PET findings were concordant in 81%, discordant findings were observed in 19%. The accuracy to diagnose tumor progression/recurrence using conventional MRI according to the RANO criteria was 82%. In contrast, the highest accuracy (95%) to diagnose tumor progression/recurrence was obtained when both a TBRmax≥2.8 and TAC pattern II or III were present (AUC, 0.966±0.02; sensitivity, 96%; specificity, 91%; P<0.001).Schlussfolgerungen/Conclusions: Dynamic FET PET may contribute to the management of patients with tumor progression/recurrence. |
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